In 2010 I made the life changing decision to undergo bariatric surgery. It was not an easy choice, and it certainly was not a shortcut. It was a lifeline. That journey opened my eyes to just how important access to the right medical tools and support can be when someone is trying to reclaim their health, their dignity and their future.
Today, GLP-1 medications used to treat obesity and diabetes are one of those tools. And right now, access to them is at risk for the very communities that need them the most.
California’s decision to remove coverage for GLP-1 medications through Medi-Cal beginning Jan. 1 sends a troubling message to Black, Latino and low-income California communities that have historically been underserved and overlooked when it comes to consistent, quality care. The message is that their health is viewed as a cost to cut instead of an investment worth protecting.
While state leaders point to the projected savings, losing access to these medications does not make obesity, diabetes or chronic disease disappear. It often means worsening health, more complications, and far greater medical costs down the road.
The newly released 2026 California State of Public Health Report makes one thing abundantly clear: chronic diseases such as obesity, diabetes, heart disease and liver disease continue to rise at alarming rates in communities of color. In San Diego County, Black residents are suffering the most from diabetes and heart disease, specifically the highest rates of diabetes deaths, ER visits and hospitalizations.
And these health issues are deeply connected. Conditions like obesity and diabetes can often lead to liver disease and fatty leader disease (MASLD). When these conditions go untreated, they can silently progress for years until they become irreversible or even life threatening, including liver cancer, which remains one of the fastest growing causes of cancer-related deaths in the United States.
GLP-1 medications are not cosmetic drugs or luxury treatments. They are evidenced-based medications that help patients manage weight, improve blood sugar control, reduce inflammation, and slow or prevent the progression of fatty liver disease. For many individuals, these medications can mean the difference between prevention and irreversible damage.
We’ve already seen what happens when obesity goes untreated. In 2022 alone, it weighed heavily on California’s economy, nearly $90 billion in lost activity and more than $10 billion in health care costs and lost revenue. But behind those numbers are real people trying to stay healthy, keep their jobs and show up for their families.
The California State of Public Health Report warns that cost-cutting measures must never come at the expense of prevention, chronic disease management or health equity. That warning should guide every decision surrounding GLP-1 access within Medi-Cal.
Because the truth is simple. It costs far more to treat kidney failure, amputations, heart attacks, strokes and liver cancer than it does to help people manage obesity and diabetes before those complications happen.
And the cost to families and communities is even greater when loved ones are lost too soon.
For generations, underserved communities have carried the burden of chronic disease while too often being denied the same health care opportunities available to wealthier or privately insured populations. We cannot continue creating a two-tiered healthcare system where some Californians are given the tools to prevent disease while others are forced to wait until they become critically ill.
San Diego’s Black, Latino and other underserved communities deserve access to every tool available to live healthier, longer and fuller lives.
Neshea V. Harrison is board president of the Liver Coalition of San Diego.
