Are weight-loss jabs creating a new advice opportunity?

More and more of the applications crossing my desk now mention Ozempic, Wegovy or Mounjaro. And it's no surprise around half a million Australians regularly use GLP-1 based medicines, and roughly half of them pay privately rather than relying on the Pharmaceutical Benefits Scheme (PBS).

Most of the public debate has centred on cost, supply and side effects. But from where I sit, the more interesting story for advisers may already be in their own client files.

Many practices have clients who were declined, postponed or charged a substantial premium loading because of their weight, a decision their financial plan has long treated as settled. Since then, some of those clients may have achieved significant, sustained weight loss and improved their broader health.

In other words, clients are taking real steps to change their health, while earlier decisions about protecting their income and families remain unexamined. That makes this one of the more unexpected advice opportunities to emerge in years. The key is knowing when a client's improved health genuinely warrants a fresh look, and what an underwriter will need to see.

Which clients deserve a second look?

Underwriting decisions are snapshots. They reflect a client's health at a particular point in time, and as circumstances change, the factors behind that decision can change too.

Insurers can't start this conversation. We can't write to someone we declined five years ago and invite them back, because we don't know what their health looks like today. Advisers, on the other hand, hold the relationship and the history, often including why a client missed out in the first place.

Alongside past declines and existing loadings, there's another group that's easy to overlook, clients who walked away because cover was simply too expensive.

Not everyone will be ready for reassessment, though. The strongest candidates are generally those whose weight was the core concern. Outcomes are less likely to change where other conditions have emerged in the meantime. Insurers load for weight because of what it can lead to, so a client who has lost weight but has since developed cancer, for example, may not see their terms move.

Diabetes adds another layer. If a client uses a GLP-1 based medicines to manage it, better control is genuinely good news, but the diabetes itself remains the central consideration for an underwriter.

When has enough really changed?

I often see two very different stories behind the same weight loss. One client has lost substantial weight over the past six months. Another lost a similar amount two years ago and has held it steadily since. Both are real achievements, but to an underwriter, the second is far more convincing.

Bodies can be stubborn. A lower weight maintained over time is more informative than a recent, rapid loss. Even then, stability is evidence of the person's current trajectory, not a guarantee that the weight will remain off - especially if treatment is later stopped. Some people discontinue treatment because of cost, access, adverse effects or personal preference. However, weight regain is common after GLP-1 based treatment is stopped, and continued treatment may be needed to maintain the result

As a practical underwriting guide, around 12 months at a lower, stable weight may provide a useful picture of the trajectory. This is not a universal clinical threshold, it's a rule of thumb, the appropriate

period depends on the individual circumstances, including the extent of weight loss, treatment indication, ongoing therapy and associated health conditions.

What may surprise some is what doesn't count for much. Taking a GLP-1 based medicine doesn't automatically lead to better terms, and neither does the length of time someone has been on it. Two years on Mounjaro tells us very little, what it has done for the client tells us a great deal. The reason for treatment, the weight loss achieved and the stability of the result matter more than the treatment duration alone.

We also look beyond the scales. Blood pressure and glucose levels matter, as do the risks rapid weight loss can include some loss of lean mass, so nutritional status and the maintenance of muscle strength are relevant. Evidence about clinically significant muscle impairment during GLP-1 based treatment remains mixed. We also consider bone health where clinically relevant, particularly when a client has other risk factors. The extent to which GLP-1 based medicines independently affect bone density remains uncertain.

None of this is about penalising people. In my experience, a GLP-1 based medicines are assessed much like any other weight-loss effort, whether that's a new gym membership or a structured diet program. Good underwriting shouldn't mark clients down for looking after their health. What we want to see is that the progress lasts. From an underwriting perspective, the method of weight loss should not determine the decision by itself. We consider the weight change and resulting health profile alongside the reason for treatment, its tolerability, relevant co-morbidities and whether progress is being maintained.

Why talk to the insurer before lodging?

"I've lost 20 kilos, so my insurance should be cheaper now, right?"

It's an understandable assumption. Some clients may even question whether they still need cover. But feeling healthier doesn't necessarily change their family's reliance on their income or the financial consequences of illness.

From the underwriting side, an early conversation is often the most useful first step, whether a client is looking to reapply or to have an existing loading reviewed. For a client who has only held their lower weight for six months, for example, it can clarify whether more time is needed and what evidence would help when the moment comes. That helps establish whether reassessment is realistic now or a goal for later.

The starting evidence is often straightforward. Pre-treatment and current weight records, the trajectory over time and a brief report from the treating GP. Depending on the case, the underwriter may also need information about the treatment indication, ongoing therapy, relevant health measures and any associated conditions. Many doctors prescribing these medications will already be monitoring their patients, so much of this information may already exist.

Knowing the likely timeframe and evidence upfront gives clients a clear goal to work towards. It also turns a one-off conversation into an ongoing one, keeping the adviser involved as the client's health, and their cover, catch up with each other.

A second chance worth exploring

The long-term evidence on GLP-1 based medicines is still emerging, and the industry will keep watching it closely. At this point, though, I wouldn't view long-term use as a negative in itself. The

established health risks associated with obesity remain substantial, and these treatments should be assessed in that broader context.

As more health-conscious consumers turn to these treatments, the gap between who clients were when they first applied and who they are now will only widen. A decision made several years ago may have been entirely appropriate at the time. Recognising when it no longer fits is where the renewed advice opportunity lies, and it starts with the clients advisers already know.