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Weight-loss medications continue to be prescribed at ‘low rates’
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Among eligible adults with overweight or obesity, only 1.3% were prescribed weight-loss medications, according to findings published in Obesity.
“Weight-loss medications are the intermediate choice between lifestyle programs and bariatric surgery in both effectiveness and cost,” David R. Saxon, MD, an assistant professor in the division of endocrinology, metabolism and diabetes at the University of Colorado Anschutz Medical Campus and the division of endocrinology at the Rocky Mountain Regional Veterans Affairs Medical Center in Aurora, Colorado, and colleagues wrote. “Despite support from guidelines and interest from patients, weight-loss medications are seldom prescribed, and prescribing habits of health care providers vary greatly.”
Saxon and colleagues identified the frequency and duration of weight-loss medication prescriptions from 2009 to 2015 in the electronic health records of 2,248,407 adults with a BMI of at least 27 kg/m2 from the Kaiser Permanente and Strategic Partners Patient Outcomes Research to Advance Learning network.
Weight-loss medications were prescribed to 29,964 individuals in the total cohort (mean age, 44.9 years; mean BMI, 37.2 kg/m2; 82.3% women). The researchers found that weight-loss medications were prescribed to 2.1% of women and 0.5% of men. In terms of BMI, weight-loss medications were prescribed to 3.4% of those with a BMI of at least 40 kg/m2, 2.2% of those with a BMI between 35 kg/m2 and 39.9 kg/m2, 1.1% of those with a BMI between 30 kg/m2 and 34.9 kg/m2 and 0.4% of those with a BMI below 30 kg/m2. In addition, weight-loss medications were prescribed to 2.1% of individuals of African American ethnicity, 1.7% of individuals of native Hawaiian or Pacific Islander ethnicity, 1.5% of individuals of American Indian or Alaska Native ethnicity, 1.3% of individuals of non-Hispanic white ethnicity, 1.2% of individuals of Hispanic ethnicity and 0.7% of individuals of Asian ethnicity.
The researchers noted that 76.6% of medication treatment days were with phentermine, even though it is only FDA approved for short-term use. The average length of a prescription was 178.3 medication days with a length of 120 or more days noted for 51.7% of the prescriptions and a prescription length of 360 or more days noted for 33.8% of the prescriptions, according to the researchers, who further noted that the number of medication days in 2015 was 32.9% greater than the number in 2009. In addition, the researchers stated that 89.6% of the prescriptions were written by 8.3% of health care providers.
“Future studies could use qualitative methods to understand the patient, provider and care environment factors that may be responsible for the low rates of prescribing observed,” the researchers wrote. “Important questions also remain about the effectiveness and safety of weight-loss medications as they are used in clinical practice.” – by Phil Neuffer
Disclosures: The authors report no relevant financial disclosures.
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