The maritime community is quite familiar with the debate over whether radio frequency ablations (RFAs) constitute curative or palliative treatment. Courts have wrestled with whether a procedure that temporarily relieves pain for around six to twelve months, but does not correct the underlying condition, falls within a vessel owner’s cure obligation. Some courts have treated RFAs as palliative treatment, placing them outside the shipowner’s cure obligation, while others have deemed them curative.¹ That debate is far from settled, but a new one is beginning to inject itself into the maritime community: GLP-1 medications.

GLP-1 drugs like Ozempic and Mounjaro require little introduction in 2026.² With the ubiquity of these so-called “miracle drugs,” treating physicians are likely already recommending them in the maritime context, particularly given that obesity has been formally recognized as a disease by the American Medical Association. The question, then, is how these medications will be classified within the maintenance and cure landscape.

Consider the following scenario. A seaman suffers a back injury aboard a vessel. His surgeon refuses to operate until he loses a significant amount of weight. His physician prescribes a GLP-1 medication to facilitate weight loss and obtain surgical clearance. The vessel owner is now potentially on the hook for a medication that treats obesity rather than the maritime injury itself. Moreover, the substantial cost of these medications is enough to leave vessel owners seasick. The hypothetical raises the question of whether the medication should be considered curative or palliative treatment.

The answer centers on a familiar maritime framework. Maintenance and cure is owed to seamen injured while in the service of a vessel.³ Cure refers to the employer’s obligation to provide necessary medical treatment to the injured seaman.⁴ The obligation ceases once the seaman reaches maximum medical improvement (“MMI”), the point at which no further treatment will improve the underlying condition.⁵ Treatment is generally considered curative when it improves the underlying condition and palliative when it merely manages symptoms.⁶ GLP-1 medications fit uncomfortably within both categories.

Much like courts have struggled to categorize RFAs,⁷ GLP-1 medications present a similar dilemma. On one hand, GLP-1 medications seem like palliative treatment because obesity does not often have a direct correlation to the maritime injury. On the other hand, the medication may become a prerequisite to curing the maritime injury itself. If a seaman cannot undergo a recommended surgery without substantial weight loss, a GLP-1 medication begins to look less like a weight loss solution and more like a necessary component of the cure itself.

The analysis becomes even more complicated where the seaman was healthy prior to the injury but gained substantial weight because of the immobility caused by the maritime injury. In that circumstance, it becomes more difficult to characterize the GLP-1 medication as unrelated to the injury itself. The medication is no longer simply treating obesity. It is addressing a condition that developed because the seaman was unable to function post-injury. Notably, ambiguities in the application of maintenance and cure are generally resolved in favor of the seaman.⁸

Even if courts fail to classify GLP-1 medications as curative, the analysis does not end there. Courts require employers to provide reasonable and necessary medical treatment, and employers bear the burden of showing that treatment is excessive or unnecessary.⁹ Thus, where a seaman has not yet reached MMI, there is a strong argument that a GLP-1 medication necessary for surgical clearance falls within the scope of reasonable and necessary treatment related to the surgery.

In Costa Crociere S.p.A. v. Rose, one court outside the Fifth Circuit discussed insulin treatment as an example of a “therapeutic” treatment that, while not curative of the underlying disease, was not merely palliative either.¹⁰ The court reasoned that insulin meaningfully sustained bodily functioning despite not curing diabetes itself.¹¹ Although Costa Crociere is not binding on Fifth Circuit courts,¹² its reasoning may be a useful roadmap for analyzing GLP-1 medications when weight loss is medically necessary for the seaman to undergo curative surgery.

The Takeaway

Maritime practitioners should begin thinking through these questions now. Courts have yet to see GLP-1 medications in the maintenance and cure context, but given the rate at which they are prescribed in 2026, they soon will. The use of GLP-1 medications may force a change in the traditional classification of curative or palliative treatment, especially when the medication is required for surgery to commence.

_______________

¹ See Brandner v. State Farm Mut. Auto. Ins. Co., CV 18-982, 2019 WL 636423 (E.D. La. Feb. 14, 2019); See Tankersley v. Protective Ins. Co., 3:22-CV-00285, 2024 WL 3171842 (M.D. La. June 25, 2024).
² Adam Pope, The GLP-1 Revolution: What UAB Researchers Are Discovering About How These Drugs Work, Research & Innovation, UAB News (Feb. 18, 2026). “GLP-1, short for glucagon-like peptide-1, is a hormone released in the gut after eating. It helps regulate blood sugar, slows stomach emptying and contributes to feelings of fullness.”
³ McCorpen v. Central Gulf S.S. Corp., 396 F.2d 547, 548 (5th Cir. 1968).
⁴ Manderson v. Chet Morrison Contractors, Inc., 666 F.3d 373, 380 (5th Cir. 2012).
⁵ Springborn v. American Commercial Barge Lines, Inc., 767 F.2d 89 (5th Cir. 1985).
⁶ Semien v. Parker Drilling Offshore USA LLC, 179 F. Supp. 3d 687 (E.D. La. 2016).
⁷ See Brandner, 2019 WL 636423; See also Tankersley, 2024 WL 3171842.
⁸ Johnson v. Marlin Drilling Co., 893 F.2d 77, 79 (5th Cir. 1990).
⁹ Matter of Cooper/T. Smith Stevedoring Co., Inc., 942 F. Supp. 267, 269 (E.D. La. 1996).
¹⁰ Costa Crociere S.p.A. v. Rose, 939 F. Supp. 1538, 1545–47 (S.D. Fla. 1996).
¹¹ Id.
¹² Id.