Just after Labor Day, movie studios become more serious-minded about the films they are releasing — with the upcoming awards season in mind.

That means titles, directors and actors will start showing up on theater marquees that studios hope will be repeated on Oscar night.

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Not that the popcorn season has popped its last kernel. Plenty of potential blockbusters will be hitting theaters this season along with expected “prestige” films.

This fall season is no exception, with awards contenders getting carted out amongst the crowd-pleasers.

And, of course, plenty of sequels, reboots and remakes will be in the picture. This fall, for example, brings the hard-luck rockers from “Spinal Tap” back to the big screen in a much-anticipated sequel. “Downton Abbey” gets a “Grand Finale.” Bill Condon offers a new take on “Kiss of the Spider Woman.” And Oscar Isaac and Jacob Elordi star in Guillermo del Toro’s new adaption of Mary Shelley’s “Frankenstein.”

In short, film fans can look forward to a rich assortment of new and time-honored cinematic stories this fall.

We took a look at a few (44!) of the most promising titles hitting theaters from Sept. 5 to Nov. 14. Note: Release dates are subject to change.

September

“Twinless”: A single-for-a-reason guy (director/screenwriter James Sweeney) enters a support group and gets cozy with a straight twin (Dylan O’Brien, in a dual role). Confused? Not to worry; this hot, cringey jaw-dropper makes sense out of an increasingly outlandish situation. (In theaters Sept. 5.)

“The Conjuring: Last Rites”: The Smurl brood from Pennsylvania hire paranormal-busters Ed (Patrick Wilson) and Lorraine Warren (Vera Farmiga) to remove a most unwelcome demonic houseguest. Billed as the final in the franchise. (In theaters Sept. 5.)

“Spinal Tap II: The End Continues”: Hollywood’s insatiable appetite for late-blooming nostalgic sequels (“Beetlejuice,” “Happy Gilmore”) continues with director/co-screenwriter Rob Reiner’s ADU to his 1984 mockumentary classic.  It takes place 41 years after with those estranged metalheads and documentarian Marty Di Bergi (Reiner) prepping for one last boisterous concert. Paul McCartney and Elton John crash the party. (In theaters Sept. 12.)

“Paper Bag Plan”: Oakland native Anthony Lucero’s big-hearted follow to his Oakland-set “East Side Sushi” follows a terminally ill father (Lance Kinsey) as he shows disabled son (Cole Massie) the ropes on bagging groceries so he’ll thrive independently. Both performances are phenomenal. (Opens Sept. 12 at the Grand Lake Theater, Oakland; Sept. 19 at Cinelux Almaden Cafe & Lounge, San Jose.)

“The Long Walk”: Some Stephen King diehards consider his 1979 dystopian psychological thriller, written as Richard Bachman, to be his bleakest. That’s saying somethin’. This one is about teen boys in an authoritarian America participating in a brutal and lethal walking contest. (In theaters Sept. 12.)

“Downton Abbey: The Grand Finale”: The 1930s prove a topsy-turvy time for the Crawleys as they weather scandal and money woes, all of which disrupt the lives of the people who work for them. (In theaters Sept. 12.)

“Demon Slayer: Kimetsu No Yaiba — The Movie: Infinity Castle”: Anime fans are already queuing up for the latest outing that’s based on the insanely popular fantasy manga and series. (In theaters Sept. 12.)

“HIM”: Executive producer Jordan Peele hands the big-league ball over to talented El Cerrito-born filmmaker Justin Tipping (“Kicks”), who directs/co-writes a sports horror story about a gifted young athlete (Tyriq Withers) training at a freaky football camp overseen by a sunsetting game veteran (Marlon Wayans). (In theaters Sept. 19.)

“A Big Bold Beautiful Journey”: Two of today’s most beloved actors — Margot Robbie and Colin Farrell — unite for a romantic fantasy wherein strangers get a chance to revisit their pasts. Kogonada (he of the the criminally underrated “After Yang”) directs. (In theaters Sept. 19.)

“The Lost Bus”: Matthew McConaughey is a school bus driver and America Ferrera is a teacher who team to save schoolchildren during the horrific 2018 Camp Fire in Butte County. Director Paul Greengrass co-wrote the screenplay. (In select theaters Sept. 19; streaming on Apple TV+ Oct. 3.)

“One Battle After Another”: Paul Thomas Anderson attempts the near-impossible again, adapting another wily Thomas Pynchon tome. (He had limited success with “Inherent Vice.”) Leonardo Di Caprio, Benicio del Toro, Regina Hall, and Sean Penn hop aboard for this wild ride wherein a pack of quirky ex-revolutionaries queue up to save one of their daughters. (In theaters Sept. 26.)

“Eleanor the Great”: In Scarlett Johansson’s directorial debut, June Squibb portrays a longing-for-connection 94-year-old who sparks the attention of a journalism student after she shares a story that’s not her own. (In theaters Sept. 26.)

October

“The Smashing Machine”: Will Hayward native Dwayne Johnson score an acting nom for his portrayal of real-life MMA fighter Mark Kerr? With Benny Safdie helming this bio-pic, it wouldn’t surprise us. (In theaters Oct. 3.)

“Anemone”: One of our acting greats — Daniel Day-Lewis — comes out of retirement for a drama he co-wrote with son, Ronan — who directs. The Oscar winner plays a hermit who reconnects with his brother decades after a traumatic incident. (In limited release Oct. 3; expands Oct. 10.)

“Shelby Oaks”: A horrifying videotape propels a woman on a hellish odyssey to pinpoint her long-missing sister. It’s YouTube sensation Chris Stuckmann’s horror debut. (In theaters Oct. 3.)

“Good Boy”: Some might well shout out “nepo puppy!” upon hearing that the doggie hero in this horror film is played by director Ben Leonberg’s retriever Indy. Don’t. Word is this effective horror ditty set in a haunted country home features star turns from its director, canine star and others in the cast. (In theaters Oct. 3.)

“Bone Lake”: Wicked and kinky games between two couples turn bloody in a cabin in the woods. This erotic horror film has been shocking early audiences. (In theaters Oct. 3.)

“Tron: Ares”:  After the meh “Tron: Legacy” (2010), Disney hopes to rev up the engines of this franchise. Jared Leto is in the driver’s seat in an AI-themed actionfest set in the real world. Original star Jeff Bridges gives it gravitas. (In theaters Oct. 10.)

“Roofman”: In this film based on a true story, a robber (Channing Tatum) camps out for six months in a Toys “R” Us store but finds that double-life challenged when he meets a customer (Kirsten Dunst). Derek Cianfrance

(“Blue Valentine”) directed and co-wrote this comedy-drama. (In theaters Oct. 10.)

“Kiss of the Spider Woman”: Both the Tony-winning musical adaptation and the 1976 novel it was based on, which also begat an award-winning 1985 feature, serve as the inspiration for Bill Condon’s music-infused version with Diego Luna, Tonatiuh and Jennifer Lopez. It’s centered on a relationship between two people in prison. (In theaters Oct. 10.)

“If I Had Legs I’d Kick You”: Rose Byrne’s gaining buzz for her committed performance as a stressed-to-the-breaking-point mom who leaps from one crisis to another. Conan O’Brien plays her not-so-helpful therapist. (In select theaters Oct. 10.)

“After the Hunt”: The past of college professor Alma Olsson (Julia Roberts) and academic egos collide when a brilliant student (Ayo Edebiri) lobs a sexual abuse accusation the way of Alma’s colleague (Andrew Garfield). Luca Guadagnino (“Call Me By Your Name,” “Challengers”) directs this conversation-starter, which sparked a vigorous post-screening convo after its Venice Film Fest screening last weekend. (Opens Oct. 10 in Los Angeles and New York; Oct. 17 elsewhere.)

“It Was Just an Accident”: Acclaimed Iranian filmmaker Jafar Panahi’s intense drama continues to gobble up awards on the festival circuit, including the coveted Palme d’Or at Cannes. The premise is a grabber: A mechanic believes he’s run into the cruel jailhouse captor from his past and takes matters into his own hands. (In select theaters Oct. 15.)

“Ballad of a Small Player”: “Conclave” director Edward Berger jumps from bishops to gamblers for this adaptation of Lawrence Osborne’s much-praised novel set in Macau. Colin Farrell rolls the dice in the lead. (In select theaters Oct. 15; available on Netflix Oct. 29.)

“Good Fortune”: The trailer alone promises huge laughs, as a bungling angel (Keanu Reeves) becomes too involved in the lives of a down-on-his-luck gig worker (Aziz Ansari, who also directs and stars) and an obscenely rich venture capitalist (Seth Rogen). (In theaters Oct. 17.)

“Frankenstein”: Mary Shelley’s Gothic classic comes to life again, this time with Oscar Isaac as Victor Frankenstein, Jacob Elordi as The Creature and Mia Goth as Elizabeth and Guillermo del Toro directing. (In select theaters Oct. 17; on Netflix Nov. 7.)

“Black Phone 2”: Villains never stay dead and buried, at least in the horror film world. Case in point: The Grabber (Ethan Hawke) who haunts the living daylights once again out of a now-17-year-old Finn (Mason Thames) and his sister at a snowed-in winter resort. Scott Derrickson returns to direct.

“Hedda”: Nia DaCosta (“Candyman”) gives Ibsen’s classic story and iconic character a modern revival with Tessa Thompson portraying Hedda, who’s confronting harsh societal expectations and demands. (In select theaters Oct. 22; available on Amazon Prime Oct. 29.)

“Regretting You”: Colleen Hoover’s tearjerker of a best seller about a mom (Allison Williams) and daughter (Mckenna Grace) and the fraught relationship between the two that settles in after a tragic accident stars Palo Alto native Dave Franco and Monterey native Scott Eastwood, as well Mason Thames. (In theaters Oct. 24.)

“Springsteen: Deliver Me From Nowhere”: Director/screenwriter Scott Cooper hones in on a pivotal period in the career of The Boss (Jeremy Allen White): the making of his brilliant 1982 acoustic album “Nebraska.” Will the smoldering star of “The Bear” land an Oscar nod like Timothée Chalamet did for playing Dylan? Looks hopeful. (In theaters Oct. 24.)

“Bugonia”: In yet another bizarre head trip from filmmaker Yorgos Lanthimos, two “worker bees”(Jesse Plemons and Aidan Delbis) become convinced a CEO (Emma Stone) is intent on obliterating our world. So they kidnap her. Will Tracy’s screenplay uses the 2003 Korean comedy “Save the Green Planet!” as its jumping off point. (In New York and Los Angeles Oct. 24; opens wide Oct. 31.)

“Blue Moon”: The often-inebriated lyricist Lorenz Hart (Ethan Hawke) hangs out at a New York bar on the eve of the premiere of his collaboration with Richard Rodgers (Andrew Scott), the musical “Oklahoma!,” and becomes smitten with an enchanting woman (Margaret Qualley). Richard Linklater directs. (In theaters Oct. 24.)

“Nouvelle Vague”: What transpired during the making of Jean Luc-Godard’s French New Wave classic “Breathless”?  Richard Linklater’s black-and-white film imagines it. (In select theaters Oct. 31; on Netflix Nov. 14.)

“A House of Dynamite”: Director Kathryn Bigelow’s thriller with Idris Elba and Rebecca Ferguson focuses on a missile getting aimed at the U.S. and the countdown over what to do next. (Available on Netflix Oct. 24.)

November

“Train Dreams”: The Sundance crowd embraced Clint Bentley’s adaptation of Denis Johnson’s novella about an early 20th century logger and railroad worker portrayed by Joel Edgerton. (In select theatres Nov. 7; on Netflix Nov. 21.)

“Predator: Badlands”: Dan Trachtenberg revitalized the “Predator” franchise in 2022 with the Indigenous-themed “Prey” and he looks to be carrying on that tradition with a futuristic rejiggering in which a Predator that’s been rejected from his clan teams with a female robot (Elle Fanning) and takes on a new nemesis. (In theaters Nov. 7.)

“Sentimental Value”: The Cannes crowd gushed over Joachim Trier’s latest drama, which reteams the director with the iridescent Renate Reinsve (“The Worst Person in the World”). She plays one of two daughters sucked into her father’s filmmaking world. (In theaters Nov. 7.)

“Nuremberg”: Pressure reaches the boiling point for a psychiatrist (Rami Malek) determining whether infamous Nazi leader Hermann Göring (Russell Crowe) is mentally sound to stand trial. Director James Vanderbilt adapts author Jack El-Hai’s “The Nazi and the Psychiatrist.” (In theaters Nov. 7.)

“I Wish You All the Best”: When their parents kick them out for revealing they’re nonbinary, Ben (Corey Fogelmanis) moves in with their estranged sister and finds connection and friendship at a new school. Tommy Dorfman steps into the director’s and producer’s chair and adapts author Mason Deaver’s heralded YA novel. (In theaters Nov. 7.)

“The Running Man”: Edgar Wright put his electrifying directorial skills to work with his take on a 1982 Richard Bachman (aka Stephen King) novel that was turned into a 1987 movie with Arnold Schwarzenegger. Glenn Powell enters the danger zone as a contestant participating in a deadly game. Colman Domingo looks to be a scene stealer as the host of “The Running Man” show. (In theaters Nov. 14.)

“Keeper”: Prolific Osgood Perkins (“Longlegs,” “The Monkey”) gives us another multi-layered horror story, this time penned by “Dangerous Animals” screenwriter Nick Lepard. It’s set in a cabin in the woods where a couple (Tatiana Maslany and Rossif Sutherland) gets sucked into a vortex of terror. (In theaters Nov. 14.)

“Now You See Me, Now You Don’t”: A diamond heist brings veteran and newbie illusionists together in the latest installment of a franchise that again boasts a killer cast (Jessie Eisenberg, Woody Harrelson, Dave Franco, Rosamund Pike, Morgan Freeman and more. (In theaters Nov. 14.)

“Jay Kelly”: With his longtime manager (Adam Sandler) by his side, an introspective 60-year-old actor (George Clooney) considers his place in the world while attending an Italian film festival honoring him. Noah Baumbach’s dramedy costars Billy Crudup, Laura Dern and Greta Gerwig. (In theaters Nov. 14.)

“Sirat”: The search for a young woman brings a father and son to a rave in Morocco in this twist-filled, genre-defiant feature from Oliver Laxe.

Contact Randy Myers at soitsrandy@gmail.com.

By CALEIGH WELLS

This idea of a carbon footprint comes up a lot in news coverage about personal climate impact.

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The concept is simple: It includes anything that you add to planet-warming emissions, ranging from the gas consumed by your car to the energy required to produce the food you eat. Reducing your carbon footprint means contributing less of these gases to the atmosphere.

But figuring out how to lower your carbon footprint is more complicated. That’s why several mobile tracking apps help people figure out which actions create the most emissions and how to avoid them.

Researchers have found that people often misjudge how their actions contribute to climate change, but can do better with more information. Apps are one way to learn more about emissions and build better habits.

So, I downloaded three popular ones. Here’s how it went.

Calculating my own carbon footprint

Two of the apps started by calculating my personal footprint. And I’ll be honest. I thought I was going to look pretty good. I was wrong.

I take my climate impact seriously. I only eat meat on weekends, and it’s almost always low-impact options like chicken and turkey. I share my car (a plug-in hybrid) with my spouse, and we both work from home. I compost, I buy in bulk and I bring plastic containers to the restaurant for leftovers, so I produce very little trash. I mean, that’s a pretty standup environmental citizen, right?

Earth Hero and Pawprint both told me I emit around 17 tons of pollution every year. Earth Hero estimates the average American emits nearly 22 tons, so I was below that. But my footprint is still three times higher than the average person globally.

The biggest culprits were the energy spent heating and cooling my old house along with twice-yearly flights I take to see my family 2,000 miles (3,200 kilometers) away.

So, armed with guilt and panic-induced enthusiasm, I set out to reduce my impact, with the help of the apps.

The lifestyle recording apps

Earth Hero and Pawprint both started with a survey about eating, travel and spending that yielded the carbon footprint calculation. (I compared it with the EPA’s calculator, and the results lined up.)

Then I scrolled through actions that could reduce my footprint. Pawprint assigns values to each action with the help of a climate impact consulting group. Earth Hero says it relies on volunteer scientists to research values for each action based on scientific data. Most of Earth Hero’s actions came with points to “level up,” but actions that can’t be easily quantified (like, “join a green team at work,”) didn’t impact my score.

Some were easy (wash clothes in cold water) and some were ambitious (install rooftop solar energy). Earth Hero allowed me to mark ones that went on my list of goals. Pawprint incentivized doing small actions repeatedly to build my list of habits, which reduced my calculated footprint.

Pawprint gave me “Pawpoints” that I could redeem for investments into climate causes. Earth Hero’s actions reduced my emissions score and leveled up my profile, which appealed to my competitive nature.

Earth Hero CEO Ben Gerhold said the average person who signs up for the app — which has 150,000 users — reduces their calculated annual emissions score by one ton.

I kept this up for two weeks. As my enthusiasm waned, so did my participation. The self reporting made for a personalized experience and set of goals, but I didn’t want to keep opening Pawprint every time I skipped a shower or ate a vegan meal. I stopped opening Earth Hero too, because after the easy stuff, I was left with pretty lofty goals, such as installing a water heater. That is on my list, but it’s not a quick task.

The passive one that monitors spending

The third app I downloaded, called Commons, didn’t require the same daily commitment.

The app, which monitors credit cards, generated weekly reports on what I’m buying. It didn’t require ongoing inputs.

After getting over nervousness about sharing credit card data, I was flooded with insights. It listed every purchase in reverse chronological order and provided a rough estimate of its carbon impact, encouraging less spending in general and more sustainable purchases.

I got rewards when I bought from a sustainable brand, which I could then redeem for gift cards. The weekly report gave me kudos for spending less on gas and for no-purchase streaks for brands that it has given poor climate ratings.

It also encourages spending goals. This month’s challenge, for example, is to buy secondhand, and I get extra rewards if I, with the 1,800 others who accepted the challenge, collectively reach our target.

Their calculations can be based on broad formulas. For example, my grocery bill is based how much I bought and not what I bought, so the $10 I spent on tofu counted the same as if I’d bought beef.

Beyond the carbon tracking

Commons’ founder, Sanchali Pal, acknowledged the carbon footprint measurements are blunt. She said monitoring purchases is meant to get users to vote with their dollars and have a larger collective impact.

“A few individuals offsetting their footprint is great, but it’s not going to shift systems,” she said. “This idea of being able to send the signal to companies to shift their behavior was a lot more powerful.”

Many of the actions in Earth Hero’s app were also about collective action. I’d get points if I wrote to my political representative or signed a petition. Gerhold said those kinds of actions are going to have a “bigger ripple effect and just go beyond a niche app.”

After using the apps, I don’t have a dramatically lower carbon footprint score to report, partly because life changes take longer than two weeks.

Still, I’m inspired to see how small I can make my footprint. I did book a more climate-friendly Christmas trip to see my family with a mixed plane and train itinerary, rather than flying the whole way. I am also planning home energy upgrades.

Might as well keep chipping away and see how far I get.

The Associated Press’ climate and environmental coverage receives financial support from multiple private foundations. AP is solely responsible for all content. Find AP’s standards for working with philanthropies, a list of supporters and funded coverage areas at AP.org.

Neither Minnesota Wild general manager Bill Guerin nor the camp representing star forward Kirill Kaprizov are saying much after the team’s potentially history-making first contract offer was reportedly rejected.

Speaking on the 10K Takes podcast this week, Guerin urged that Wild fans stay calm, saying he feels the team is “still in a really positive place with Kirill.”

The team would clearly like to have a deal in place before Game 1 of the regular season — Thursday, Oct. 9 in St. Louis — for multiple reasons. But if an impasse is reached, the nuclear option for Guerin and the Wild would be to explore an in-season trade and see what they can for Kaprizov rather than watch him walk away with no benefit, immediate or long-term, to the franchise.

Pittsburgh Penguins’ Bill Guerin celebrates his goal against the Philadelphia Flyers during the first period of an NHL hockey game in Pittsburgh on Tuesday, Dec. 15, 2009. The previous spring. he was traded from the New York Islanders and helped the Penguins win a Stanley Cup. (AP Photo/Gene J. Puskar)

It’s a scenario Guerin knows from first-hand experience. In March of 2009, when he was captain of the New York Islanders, Guerin was traded to the Pittsburgh Penguins and won his second career Stanley Cup there a few months later. The Islanders got what became a third-round draft pick in exchange for Guerin.

For Wild fans, one more potentially troublesome factor iis the history of moves like that one. In general, teams that acquire a star player do better in the short term than the team getting multiple role players and draft picks in exchange for one top-level asset.

The Wild are likely a long way from even considering that idea for Kaprizov, who has been the offensive leader since he joined the team for the 2020-21 season — 185 goals and 386 points in 319 games — but if he were to waive his no-movement clause and allow the Wild to shop him around, he would command considerably more than a third-round pick.

Big names in new places

Just last season, the Colorado Avalanche reached an impasse with their leading scorer, star forward Mikko Rantanen, who was in the final year of his contract with the team. Rather than see him walk away as a free agent last summer, Colorado traded Rantanen to the Carolina Hurricanes in January. In return, the Avalanche received two players and two draft picks.

Rantanen’s tenure in Raleigh was barely long enough to sell any replica sweaters. He also was unable to reach a long-term contract agreement with the Hurricanes and was traded again, to Dallas, after just 13 games in Carolina. Worse, Rantanen and the Stars wound up eliminating Colorado in Round 2 of the NHL playoffs last spring.

It was medical treatment, less than money, that prompted the Buffalo Sabres to unload their biggest star, former Hobey Baker winner Jack Eichel, to the Vegas Golden Knights in November 2021.

After being the second overall pick in the 2015 NHL Draft behind Oilers superstar Connor McDavid, Eichel had put up impressive numbers for a Sabres team that was going nowhere. After injuries cost Eichel much of the previous season, and he was at loggerheads with Buffalo management about his best path back to good health, the Sabres sent him to Vegas in exchange for two players and two high draft picks.

Buffalo remains solidly on the outside of the playoff picture, and Eichel was a key factor in the Golden Knights’ winning their first Stanley Cup in 2023.

San Jose Sharks’ Joe Thornton is pictured during an NHL hockey game against his former team the Boston Bruins on Oct. 29, 2019, in Boston. Traded to San Jose in 2005, the center later helped the Sharks reach the Stanley Cup final. (AP Photo/Winslow Townson)

Moves with mixed results

Two decades ago, star defenseman Joe Thornton forced his way out of Boston, and the Bruins traded the former first overall draft pick to San Jose for a trio of regulars — Marco Sturm, Wayne Primeau and Brad Stuart. One could argue that the trade was a win for Boston, which won a Stanley Cup six years later, while the Sharks reached the final once with Thornton but still have no NHL titles on their resume. But Sturm, Primeau and Stuart were all employed elsewhere by the spring of 2011, when the Cup last visited Boston.

Current Islanders head coach Patrick Roy has some experience with the in-season trade game. After backstopping the Montreal Canadiens’ most recent Stanley Cup win in 1993, a strained relationship with coach Mario Tremblay blew up in December 1995 when Tremblay left Roy in the net for nine Red Wings goals in an eventual 11-1 loss to Detroit.

When Roy finally left the ice, he demonstratively told team owners seated behind the home bench that he had played his final game in Montreal. Forced to move their puck-stopping mainstay, Montreal shipped Roy to Colorado, and five months later in the spring of 1996, Roy was the defensive catalyst for the first Avalanche Stanley Cup title.

There is likely still much discussion that will be had between the Wild brass and the Kaprizov camp, but if an impasse is reached, NHL history shows there are in-season trade options. They just tend to favor the team, in this equation, that would receive Kaprizov.

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By Jamie Ducharme, KFF Health News

After losing 50 pounds on the injectable weight loss medication Zepbound, Kyra Wensley received a surprising letter from her pharmacy benefit manager in April.

Her request for coverage had been denied, the letter said, because she’d had a body mass index of less than 35 when she started Zepbound. The 25-year-old who lives in New York had been taking Zepbound without incident for months, so she was confused: Why was her BMI, which had been around 32 when she started, becoming an issue only now?

Wensley had no interest in quitting an effective drug. “Going right off like that, it’s easier said than done,” she said.

Her doctor fought to keep her on the GLP-1 agonist, the category that includes weight loss and Type 2 diabetes drugs Ozempic, Wegovy, Mounjaro, and Zepbound. But Wensley ultimately had to switch from Zepbound to Wegovy to meet her plan’s requirements. She said she doesn’t like Wegovy as much as her old medication, but she now feels lucky to be on any GLP-1.

Kyra Wensley’s doctor fought to keep her on the injectable weight loss medication Zepbound, but Wensley ultimately had to switch to Wegovy, a different GLP-1 agonist, to meet her health plan’ s requirements. ((Lori Wensley)/KFF HEALTH/TNS)

Lots of research suggests such medications must be used indefinitely to maintain weight loss and related health benefits. But with list prices of roughly $1,000 a month, public and private payers are struggling to keep up with ballooning demand for GLP-1 weight loss drugs and in some cases are eliminating or restricting their coverage as a result.

North Carolina Medicaid plans to end GLP-1 coverage for weight loss on Oct. 1, just over a year after starting the coverage. Pennsylvania is planning to limit Medicaid coverage to beneficiaries at the highest risk of complications from obesity. And despite recent reports of a potential federal pilot program to extend coverage of GLP-1 obesity drugs under Medicaid and Medicare, all state Medicaid programs are likely to be under pressure due to steep spending cuts in the budget reconciliation package recently signed into law by President Donald Trump.

Already, many GLP-1 users quit within a year, studies suggest — often due to side effects, high costs, or insurance issues. Now a growing number of researchers, payers, and providers are exploring deliberate “deprescription,” which aims to taper some patients off their medication after they have taken it for a certain amount of time or lost a certain amount of weight.

The U.K.’s National Institute for Health and Care Excellence, which creates guidance for the National Health Service, recommends two-year limits on the use of some weight loss medications, such as Wegovy. And the concept was raised in a recent Institute for Clinical and Economic Review report on affordable access to obesity drugs.

A. Mark Fendrick, who directs the Center for Value-Based Insurance Design at the University of Michigan, has argued that if some people using GLP-1s to lose weight were eventually transitioned off, more people could take advantage of them.

“If you’re going to spend $1 billion or $100 billion, you could either spend it on fewer people for a long period of time, or you can spend it on a lot more people for a shorter period of time,” he said.

Fendrick’s employer, the University of Michigan, indeed does that. Its prescription drug plan caps coverage of GLP-1 drugs at two years if they’re used solely for weight loss.

Jamie Bennett, a spokesperson for Wegovy and Ozempic maker Novo Nordisk, declined to comment on the concept of deprescription, noting that its drugs are intended for chronic conditions. Rachel Sorvig, a spokesperson for Zepbound and Mounjaro manufacturer Eli Lilly, said in a statement that users should “talk to their health care provider about dosage and duration needs.”

Studies have shown that people typically regain a substantial amount of weight within a year of stopping GLP-1 medications, and that many people who quit ultimately go back on the drugs.

“There’s no standard of care or gold standard on how to wean right now,” said Allison Adams, an obesity and internal medicine doctor with UK HealthCare in Kentucky.

But the math shows why time-limited coverage is appealing to payers that struggle to pay for beneficiaries’ GLP-1 prescriptions, said Michelle Gourdine, chief medical officer for the pharmacy benefit manager CVS Caremark.

And states are “between a rock and a hard place,” said Kody Kinsley, who until January led North Carolina’s Health and Human Services Department. “They’re going to have to look at every single thing and trim dollars everywhere they can.”

Pennsylvania was looking for cost-saving strategies even before the new federal tax-and-spending law, according to Brandon Cwalina, press secretary for the state’s Department of Human Services. Pennsylvania projects it will spend $1.3 billion on GLP-1 drugs this year.

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Plans could see real savings, Fendrick said, if they covered GLP-1s for initial weight loss then moved people to cheaper options — such as more affordable drugs or behavioral health programs — to maintain it.

Plenty of companies are eager to sell insurers, employers, and individuals on behavioral alternatives. One is Virta Health, which advertises its nutrition-focused weight management program as “a proven approach for deprescribing GLP-1s when clinically appropriate.” A Virta-funded study assessed 154 people with Type 2 diabetes who stopped using GLP-1 medications but continued following Virta’s program, concluding that their weight did not significantly increase after a year.

Researchers affiliated with a European weight management company also recently reported that slowly tapering off the medications may help maintain weight loss.

For employers and insurers, the “initial question” was whether to cover GLP-1s for obesity, said Virta CEO Sami Inkinen. “Now, basically, everyone’s coming to the middle and asking, ‘How do we responsibly cover these drugs?’”

Part of responsible coverage, Inkinen said, is providing other forms of support to patients who stop using GLP-1 medications, by choice or otherwise.

For some people, however, maintaining weight loss without a GLP-1 remains a challenge, even with other options available.

Lily, who lives in Michigan, lost almost 80 pounds in roughly 18 months on Wegovy. But she had to quit the drug when she turned 26 and left her parents’ insurance plan this year. The plan her employer offers stopped covering GLP-1s for weight loss right around the time she joined.

Lily, who asked to be identified by only her first name because she is not out to her family as transgender, has tried other medications since then, and previously tried lifestyle programs to control her weight. But she said nothing works as well for her as Wegovy.

She has regained 20 pounds since going off the drug at the beginning of the year and worries that number will continue to rise, potentially contributing to future health problems.

“Just give people the drugs,” she said. “It seems cheaper and safer in the long run.”

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