The GLP-1 Effect: Hype vs. Reality in Underwriting

Across the cases we see at SPG Life & Annuity, GLP-1 medications – Ozempic®,Wegovy®, and Mounjaro® – have moved from occasional outliers to everyday underwriting considerations. As a result, how these drugs are viewed in the underwriting process continues to evolve and understanding how carriers assess GLP‑1 use can make a meaningful difference in case outcomes.

The Key Underwriting Question – What Underwriters are Actually Looking At

Contrary to common assumptions, most underwriters do not focus on the medication itself. Instead, underwriting centers on:

• Why the GLP‑1 was prescribed;
• How long the client has been on GLP-1 therapy;
• Stability and trends in weight, A1c, and overall metabolic control; and
• Presence or absence of comorbidities (e.g., diabetes complications, cardiovascular disease).

In many cases, underwriters view GLP-1 cases as a positive indicator of proactive health management, particularly when it results in sustained weight loss and improved lab values.

Weight Loss vs. Underlying Risk – The Distinction that Determines the Outcome

A critical underwriting distinction is whether GLP‑1 is being used for:

• Weight management without significant comorbidities; or
• Type 2 diabetes with associated complications.

Clients using GLP‑1s solely for obesity – especially with improving BMI and no adverse labs – may still be eligible for competitive offers, including preferred classes. Conversely, GLP‑1 use layered on top of poorly controlled diabetes or significant cardiovascular history will shift the underwriting focus back to the underlying risk, not the drug.

Timing Matters – Why Early Positioning Wins

One of the most important factors is duration of use. Many carriers want to see at least 6–12 months of documented stability, evidence that weight loss is sustained – not recent or rapidly fluctuating – and that there are no material side effects or compliance concerns.

GLP‑1 medications do not automatically improve or worsen an underwriting class.

SPG Life & Annuity’s underwriting team tracks how carriers interpret GLP-1 cases in real time – when guidelines and clinical data are moving targets, context, documentation, and underwriter interpretation can make or break an outcome. Because these cases vary widely by carrier, bringing them to our team early means we can position the risk correctly, build the right narrative, and negotiate for the most competitive offer available.

When positioned correctly, cases involving GLP‑1 can often receive more favorable consideration than may be expected.

Case Study

A 52‑year‑old non-smoking male, 5’10”, applied for $5M of VUL coverage. At peak weight, he was 252 lbs. with no history of diabetes, cardiovascular disease, or other significant comorbidities. He began a GLP‑1 medication for weight management approximately 10 months prior to application.

At the time of underwriting:

• Current weight was 208 lbs., with steady well documented loss;
• Weight had been stable for several months;
• Labs, including A1c and cholesterol, were within normal limits; and
• No adverse side effects or compliance concerns were noted.

While initial concern was raised due to GLP‑1 use, underwriting ultimately focused on improving and stabilizing the risk profile rather than the medication itself. SPG Life & Annuity successfully targeted the best carrier for this case and negotiated a Preferred Non-Tobacco offer.

Key Lesson: Documented, sustained weight improvement supported by clean labs can materially improve underwriting outcomes – GLP‑1 use alone is rarely the deciding factor.

These cases demand the right narrative and carrier selection. Involve SPG Life & Annuity early and we will advocate for the strongest possible outcome for your client. Give us a “shot” at your GLP‑1 cases!