Legislators need to reinstate GLP-1 as a Medi-Cal obesity treatement

Capitol Weekly welcomes Opinions on California public policy or politics. Please read our guidelines for opinion pieces before submitting an Op-Ed. Submissions that do not adhere to our guidelines will not be considered for publication. 

OPINION—I have lived with chronic obesity for a long time. For decades, it shaped every part of my health and increased my risk for chronic disease even though I did what doctors and public health experts told me to do by following nutrition programs, exercising, staying disciplined, and even underwent a sleeve gastrectomy bariatric surgery.

None of these treatment options worked for me and led to my highest weight of 330 pounds. After decades of failed treatment options, my doctor finally prescribed a treatment that does work for me, a GLP-1.

Having access to this weight management medication changed my life and allowed me to reach a healthy BMI, which I had never experienced as an adult, and it significantly lowered my blood pressure.

Now, I’m terrified that all that progress could be undone and return me to where I started. The treatment did not fail, but the California Medicaid (Medi-Cal) coverage for obesity medications for individuals whose primary diagnosis is chronic obesity abruptly ended January 1, 2026.  Unfortunately, it has been suggested that these people, including myself, should “make diet changes and increase exercise,” but that ignores the fact that many of us have already spent decades doing exactly that.

Telling someone who has exhausted every option to simply “try harder” is not medical care even though every major medical organization recognizes obesity as a chronic disease. The evidence is overwhelming. Obesity is driven by biology, genetics and the environment. It is not a personal failure.  Untreated chronic obesity can progress into diabetes, heart disease, sleep apnea, kidney disease, disability and other expensive conditions. Those outcomes cost far more to manage than obesity itself, and experts warn the state may ultimately spend more as patients lose stability and require intensive care.

Without Medi-Cal coverage, I would be unable to afford my GLP-1 medication or any other alternative. Like many in my community, I don’t have private insurance and paying out of pocket would put an impossible strain on my already tight budget. I’ve researched my options without coverage and I have not found a solution. Losing access to my GLP-1 medicine means losing my stability, my health and my ability to care for my family.

I am not alone. The nearly 30% of Californians who live with obesity deserve access to the medications they need to stay healthy.  Our state prides itself on leading with science, equity, and compassion, but eliminating chronic obesity treatment reinforces stigma and ignores evidence. California has created a weight-biased policy, one that places the burden of treatment on the individual instead of recognizing chronic obesity as a medical condition requiring ongoing care.

It doesn’t have to be this way. California state lawmakers can reinstate GLP-1 medication coverage for the treatment of obesity on Medi-Cal. I urge each of our lawmakers to let patients get the treatment our healthcare providers prescribe that is supported by science.

It’s time for California to empower patients like me to take control of their health and lives.

Shekinah Samaya-Thomas is a member of The Obesity Action Coalition, a citizen advocate and an adult educator who lives in Oakland with her husband.