I doubt it's anywhere near that clearcut. "Weight" by itself is neither a disease nor a symptom. I have read numerous reports saying that weight loss often does not improve outcomes for various specific problems. Or that weight loss can help, but the way that it is lost matters more than the amount lost, and losing it the wrong way can be worse than maintaining the original weight. Not to mention that there are plenty of healthy overweight people and unhealthy skinny people. So I wouldn't be surprised if insurance companies are sitting back to see what the empirical effects of semaglutide-induced weight loss are on health outcomes. Perhaps there are data available on that now; I haven't looked.

Besides, it's hard to know what the health effects really are of being overweight, because it's such a convenient rug for doctors to sweep any and all problems under. "Let's see if you still have this problem after you've dropped 20 pounds, ok?" Because clearly your weight is due to a moral failing, and it suggests you're probably screwing up all kinds of other things. Why bother to work on helping you when you're unwilling to even try to do your part? Fat => lazy and weak-willed => won't stick to medication schedule or exercise or diet or anything => unworthy of help. There's not a lot of questioning whether being overweight is an effect or has a common cause; it's assumed to be the relevant cause, or at least has a high enough probability of being the only relevant cause worth looking at because it's common knowledge.

(Neither I nor anyone in my immediate family are overweight, by the way, so don't ignore my rant by assuming I'm being bitter about personal experience.)