Pay Dirt is Slate’s money advice column. Have a question? Send it to Kristin and Ilyce here. (It’s anonymous!)

Dear Pay Dirt,

Our insurance doesn’t cover GLP-1s, so I currently spend about 80 percent of my budgeted “fun money” on mine. My husband’s upset because he wants to go out to concerts or vacations together, but I can’t afford it the way I used to. He thinks it’s unnecessary and I should give it up because I don’t have any metabolic/blood pressure/cholesterol health problems. He’s naturally skinny so he doesn’t get it.

I was about 30 pounds overweight my whole adult life, despite daily running and lifting and a careful diet. The weight went up if I changed that routine, but it never went down. Until I went on a GLP-1 last year and lost it easily. With it I’m seeing huge changes: doctors take me seriously about sports injuries or my lifelong asthma. Neither has changed but my medical experiences are much better. Strangers are kinder. It’s easier to fit clothes, and the world feels designed for me. But the most damning difference is work.

I’ve been in the same job for about three years, and doing the work of a role above me for almost two. They kept saying I “wasn’t ready” for promotion, but never giving specifics. I job searched but my field is decimated by recent federal policy. After the weight loss, my managers were suddenly commenting on my “focus” “work ethic” and “improved polish with clients.” I definitely started getting positive comments about my professionalism a few months into my GLP-1, and I wasn’t doing anything different at work. I got promoted. It’s mostly going towards increased cost-of-living, nothing sexy. But it’s clear to me that my weight is a key to getting taken seriously so I can’t afford to gain it back. My doctor says if I go off it, I’ll likely regain even with a solid diet routine.

How do I find a way forward with my husband on this? I also would love to go on an expensive vacation, but not so badly I’d go back to the way I was treated before. I could switch to a sketchier online pharmacy but I’m reluctant to do that. At the same time, I don’t want to hold our hobbies hostage to non lifesaving pharmaceuticals?

—Not Essential, But Really Not Optional

Dear Not Essential, But Really Not Optional,

From where I sit, your husband is missing the whole point. He’s framing this as a fun-money tradeoff–concerts vs. prescriptions–when what you’re making is a career and health investment. This isn’t “fun money.” It’s an investment in your career, which has already paid off with a whole lot of positive feedback from your superiors, not to mention a raise. Weight bias is well-documented, and it sounds as though you’ve experienced more than your fair share.

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So, it’s time to change the framing. Stop having this conversation as a “fun money” problem. Instead, treat it as a household budget problem. If this medication protects your earning power and enhances your medical care, it belongs in the same category as your commute or your professional wardrobe and should be treated as a shared household expense, not your personal indulgence. That reframing alone may change the tone of the conversation, because right now your husband thinks you’re choosing a luxury item, like a monthly facial, over him.

Next, is there a way to find additional funding? Check whether your employer’s plan has an appeals process or whether a different plan during open enrollment covers GLP-1s. Ask your doctor about manufacturer savings programs, whether a compounded version through a legitimate telehealth provider is an option, or if you can take the pill version, which is far less expensive and may be covered by some formularies. Just skip the “sketchy online pharmacy,” because that could be a real safety risk.

Finally, you and your husband need to have a heart-to-heart over the heartless and thoughtless way you’ve been treated over the years, by doctors, strangers, your own employer and, yes, your husband. Hopefully, he recognizes how wrong he has been and offers to help find a way to afford your medication and the travel he craves. If not, then your marriage has bigger problems than a tight budget.

—Ilyce

Classic Prudie

My husband and I were recently on a trip to a resort in Mexico. We ran into some friends of ours who were traveling with their college-age teen daughter. My husband was very friendly with the daughter as he enjoys talking with young people.

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