Whats Coming: The BALANCE Model (May 2026) The biggest development in Medicaid GLP-1 coverage is the BALANCE Model (Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth), announced by CMS in December 2025
This can lead to quick weight loss but often comes with side effects like fatigue, irritability, and increased cravings
Take a deep breath and relax Tired
During this time, some patients may see a slight reduction in appetite, while weight loss is often modest
As there was clear evidence of clinically significant weight loss from the Phase III trials, tirzepatide has been planned to be evaluated as an anti-obesity drug in non-diabetic (SURMOUNT 1 trial), and diabetic (SURMOUNT 2 trial) populations, and on those who are already on intensive lifestyle programmes (SURMOUNT 3 trial)
Finding out about pregnancy safety concerns AFTER youve already been through fertility treatments while taking GLP-1s can be really scary