This week, Gov. JB Pritzker opened up about his experience using a GLP-1 medication and the impact it has had on his health. I applaud his willingness to share his story because as a physician, I have seen few diseases as misunderstood, undertreated and unfairly judged as obesity.

For decades, it has been seen as something patients could overcome through lifestyle changes rather than recognized for what it is: a serious, chronic disease linked to diabetes, heart disease, stroke and high blood pressure. Now we know that biology plays a significant role. Research shows that 40% to 70% of obesity risk is genetic. If diet and exercise alone were enough to overcome genetics, we would not see obesity at the scale we do today.

Unfortunately, Illinois Medicaid does not cover obesity medicines, putting some of the most effective treatments available out of reach for nearly 3 million Illinois residents who also deserve equitable care. This matters in a state where 69% of adults are living with obesity or are overweight. A GlobalData analysis estimates obesity contributes to 23,000 premature deaths in Illinois each year and costs state and local government $2.6 billion annually.

Behind every one of those numbers is a patient in my exam room, often someone who has tried diet after diet without success while struggling with a disease driven far more by biology than by behavior alone. Obesity is a chronic disease, and chronic diseases require ongoing care. Like hypertension or diabetes, it cannot be treated with a one-time fix.

GLP-1 medications are the most significant medical advance in the treatment of obesity and metabolic disease in decades. In my practice, I have watched patients achieve sustained weight loss while their blood sugar improves, their blood pressure comes down, and their risk of heart attack and stroke drops. Emerging research shows promising results across an expanding range of chronic health conditions.

In interviews, Pritzker described how treatment improved his blood sugar enough that he was able to stop taking insulin. It’s a powerful example of how early treatment can help prevent more serious and costly complications.

Yet these life-changing medications are only available to some of my patients. Those with the means to pay out of pocket may have access. Illinois Medicaid patients do not. That gap falls hardest on the patients who can least afford it. Communities of color and low-income neighborhoods already face higher rates of obesity, diabetes and heart disease because of long-standing gaps in access to health care, preventive care and affordable healthy food.

Illinois already spends an estimated $1.2 billion a year in higher Medicaid costs tied to obesity. The question isn’t whether obesity is costing taxpayers. The question is whether we continue paying to treat preventable complications or invest earlier in evidence-based care.

Illinois would not bear the cost of expanded coverage alone. Medicaid costs are shared with the federal government, while rebates and other pricing agreements with pharmaceutical manufacturers can further lower the state’s share. The same GlobalData analysis estimates that meaningful, sustained weight loss for Medicaid patients could save Illinois between $21.2 billion and $40.3 billion in cumulative medical cost savings over the next decade.

Pritzker deserves credit for speaking candidly about the treatment that has worked for him and helping confront the stigma that still surrounds obesity and its treatment. As physicians, we are trained to look beyond today’s symptoms and focus on long-term health. Illinois lawmakers should do the same by expanding Medicaid coverage for obesity treatments so physicians can provide the care their patients need, regardless of income.

Dr. Disha Narang is an endocrinologist and obesity medicine physician in the Chicago area.

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