Skin in the game: Does paying for obesity treatment out of pocket lead to better outcomes compared to insurance coverage?

Objective To determine whether insurance coverage for medical weight loss treatment was associated with different program engagement and weight loss outcomes compared to those who paid out of pocket. Methods One‐year outcomes from an academic medical weight management program were used to compare two groups: employees (n = 480) with insurance coverage (“covered”) versus nonemployees (n = 463) who paid out of pocket (“self‐pay”). Demographics and weight were ed from medical records. Socioeconomic status was estimated using neighborhood demographics. Group differences in weight were analyzed using generalized linear modeling adjusted for age, baseline BMI, sex, program type, and neighborhood socioeconomic status. Results Covered patients were younger (46.5 ± 10.6 vs. 51.6 ± 12.5) with a lower BMI (38.5 ± 7.5 vs. 41.3 ± 9.9) compared to self‐pay (P