Starting Jan. 1, New Hampshire’s Medicaid program will stop covering GLP-1 drugs — Wegovy, Zepbound, and others — for weight loss.

“We looked at the way that the state was supporting coverage for GLP-1 medicines and found that this was a fairly significant cost driver,” Gov. Kelly Ayotte told reporters on Wednesday. “And so we looked at the medically necessary reasons for it in terms of those who had pre-existing conditions and made the decision working with Health and Human Services to come up with a modified policy that will still allow medications in those circumstances, but then really make sure it is cost sustainable going forward.”

The Alliance for Women’s Health and Prevention wrote a letter to Ayotte Tuesday urging her to reconsider the decision. The organization noted that approximately 30% of women in New Hampshire — and a disproportionately large number of women of color — experience obesity and that obesity is associated with over 200 health complications, citing the American Medical Association and KFF.

Ayotte said Wednesday she would not reconsider the decision.

There are roughly 186,000 enrolled in Medicaid in New Hampshire, according to the Centers for Medicare and Medicaid Services. About 54% of them are women.

“When we’re talking about 180,000 enrollees, children and adults, that’s over 90,000 women who are Medicaid beneficiaries who may be living with obesity and could take advantage of receiving the obesity management medications basically to stem those comorbidities that are associated with living with obesity,” Millicent Gorham, CEO of the Alliance for Women’s Health and Prevention, said in a phone interview with the Bulletin Thursday. “We’re talking about diabetes and high blood pressure and cardiovascular disease and cancer. So if we can stem those diseases, then hopefully we can have more healthier people living in New Hampshire.”

Gorham said the change, announced by the Department of Health and Human Services in October, may provide short-term cost savings but will be more expensive in the long run.

“People are going to be living longer with obesity, which is going to lend to any number of the other 200 comorbidities that are aligned with living with obesity,” she said. “And clearly, when you’re talking about things like diabetes and cardiovascular disease and high blood pressure and cancer and fertility issues that are specific to women, they’re going to end up with higher costs specifically related to those diseases and also specifically related to higher hospitalization costs.”

Gorham pointed to the stigma surrounding obesity and weight loss drugs.

“People really may not understand that people living with obesity is not just about an alternative lifestyle,” she said. “It really is a chronic disease. That’s the first thing that they need to understand: It is a chronic disease, no different than high blood pressure, no different than diabetes, and we need to treat it like that. No other disease has to take on the kind of scrutiny that obesity takes on.”

The Alliance for Women’s Health and Prevention has launched a nationwide effort with a coalition of other health advocacy groups called Everybody Covered to push policymakers to improve coverage of GLP-1 drugs and other obesity treatments.

As of October, 16 states cover GLP-1 drugs, according to KFF. In addition to New Hampshire, California and South Carolina plan to end coverage of the drugs in January. North Carolina ended coverage last month while Michigan plans to limit coverage to people who are “morbidly obese.” The states say they can’t afford the drugs.

The Alliance for Women’s Health and Prevention has been lobbying several states to maintain coverage of the drugs. Gorham said New Hampshire’s response has been “pretty much kinda the same” as other states.

GLP-1 drugs have been shown to be effective for weight loss, though they come with a number of side effects for some patients, including nausea, vomiting, headaches, diarrhea, and constipation, according to Harvard Medical School and the Cleveland Clinic. While some experts and researchers have concerns about the drugs’ long-term impact and safety, many argue the benefits outweigh the known risks.