Compelling Grounds: Why a Semaglutide Prevention Program Could Reshape Mexico's Health System

The health crisis gripping Mexico has a silent, slow, and devastating root cause: morbid obesity. This is not merely an aesthetic problem or an individual challenge; it is the foundation on which many of the country's deadliest and most costly diseases are built. Among them, one has climbed the rankings at an alarming rate: chronic kidney disease (CKD).

In 2021, CKD became the fifth leading cause of death in Mexico. Most critically, its impact has grown at an explosive pace: between 1990 and 2017, associated mortality increased by 102 %, a reflection of the accelerated deterioration of public health. The human suffering behind these figures is immense, but so is the financial burden falling on the IMSS and, ultimately, on the Mexican state.

Given this landscape, ignoring innovative solutions is a luxury the country can no longer afford. That is why the pilot program of semaglutide for patients with morbid obesity, paired with nutrition support, physical activity, psychological care, and clinical follow-up, is not merely a reasonable option: it is an urgent necessity.

A Health Problem Overwhelming the IMSS

People with severe obesity face a higher risk of developing type 2 diabetes, hypertension, cardiovascular disease, and, especially, kidney damage. Each of these conditions is costly, complex, and requires prolonged medical intervention.

But when kidney disease progresses unchecked and a patient reaches the point of needing hemodialysis, the cost to the state skyrockets.

The numbers are stark:

• The lifetime cost of a patient on hemodialysis is approximately one million three hundred thousand pesos ($1,289,291 pesos).
• By contrast, the per-patient cost of comprehensive semaglutide treatment over 68 weeks is $136,283 pesos.

That means preventing a single case can represent savings for the IMSS of more than one million pesos per patient ($1,153,000 pesos). In a pilot covering just 1,000 patients, estimated savings exceed $1,153 million pesos.

It is hard to find, in any public policy, a clearer, faster, or more humanly significant return.

Semaglutide: a Prevention Tool with Solid Evidence

The pilot program proposal does not rest on an uncertain experiment: it is grounded in robust scientific evidence. The STEP trials, a clinical study evaluating semaglutide's efficacy published in prestigious journals such as The New England Journal of Medicine, show that semaglutide at a dose of 2.4 mg, combined with lifestyle changes, achieves average weight losses of more than 17.5 %, and in many cases exceeds 25 %. This level of reduction is not merely cosmetic: it fundamentally transforms the metabolic risk profile of patients.

In people with obesity but without diabetes, semaglutide reduces the risk of developing type 2 diabetes. This alone would prevent thousands of complications (amputations, blindness, diabetic foot, heart attacks) that each year overwhelm IMSS hospitals.

And most importantly: an effective preventive treatment halts progression toward chronic kidney disease, which means avoiding human suffering, years of life lost, and a severe financial drain on the state.

Why Is This Beneficial for Mexico's Most Vulnerable?

Because those who suffer most from the consequences of obesity are not those who can afford private treatment, but the millions of Mexicans who depend on the public system.

Progression toward diabetes or kidney disease does not only mean physical suffering:

• it dramatically reduces productivity
• it generates catastrophic expenses for low-income families
• it impacts caregivers
• it perpetuates poverty.

Preventive policies are, therefore, social policies. A program like this offers patients something the system currently does not provide: a clear path to reclaiming health before reaching irreversible complications.

Benefits for the Government: Prevention that Saves and Strengthens the System

The initial investment in semaglutide may appear high, but when compared to the costs of advanced disease, the logic is undeniable. The pilot program would allow:

Every patient who avoids hemodialysis represents savings of more than one million pesos. With 1,000 patients, the IMSS saves more than 1,153 million pesos. With 10,000, the figure reaches 11 billion pesos.

Freed hospital beds, reduced emergency visits, and lower demand for highly specialized therapies allow the system to operate more efficiently.

Less chronic illness means healthier workers and fewer disability claims, which directly benefits the economy and the IMSS itself as an insurer.

The program helps decelerate obesity prevalence by 2030, aligned with Sectoral Program indicators, and contributes to the human and financial sustainability strategy of the health sector.

A Pilot That Can Transform Public Policy

The pilot's success would allow the strategy to scale, securing better bulk-purchase prices, improving clinical protocols, and building institutional capacity. Beyond the medication itself, this generates systemic benefits:

• better processes
• greater professionalization
• institutional learning
• a replicable model for other chronic diseases.

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In a country where treatment is far more expensive than prevention, programs of this kind represent structural shifts, not temporary stopgaps.

Prevention Costs Little; Failing to Prevent Costs Lives and Fortunes

Mexico is at a critical juncture. Chronic kidney disease and diabetes are consuming public resources, lives, and opportunities. The IMSS has before it a high-impact, evidence-grounded alternative: a semaglutide pilot program that can improve the health of thousands and save billions of pesos.

Investing in prevention is not only sensible: it is an act of public responsibility and social justice. To ignore it would be to perpetuate a model that has already shown its limits and that the country simply cannot continue to finance.