Pharmacotherapy for Obesity-Trends Using a Population Level National Database.

Pharmacotherapy for Obesity-Trends Using a Population Level National Database.

Elangovan A; Shah R; Smith ZL

Obesity Surgery

2020

2020-09-28

BACKGROUND: Despite the growing trend of obesity, the utilization of anti-obesity therapeutic interventions is not robust in the USA. We aimed to analyze the trends of anti-obesity pharmacotherapy using a population level database. METHODS: We used an electronic health record-derived database (Explorys, IBM Watson Health) to identify adults with obesity (body mass index ≥ 30 kg/m(2)), 2010-2019. Annual rates of anti-obesity pharmacotherapy were analyzed. To assess post-bariatric utilization of these medications, the trend of adults with morbid obesity (BMI ≥ 40 kg/m (2)) who were newly started on anti-obesity medications after sleeve gastrectomy was also analyzed. RESULTS: Among 11,195,020 adults with obesity, 274,160 (2.4%) were prescribed anti-obesity medications during the study period with an increase from 1.1% in 2010 to 2.9% in 2019 (p < 0.0001). A total of 900 (3.5%) of those with morbid obesity were started on weight loss medications within 5 years of sleeve gastrectomy. Women [odds ratio (OR) 3.57, 95% confidence interval (CI) 3.51-3.58], individuals under 50 years (OR 1.59, CI 1.57-1.60), non-Hispanics (OR 1.12, 1.10-1.14, p < 0.0001), African Americans (OR 1.18, CI 1.16-1.19), Medicaid (OR 1.70, CI 1.67-1.73), and commercial insurance holders (OR 2.46, 2.43-2.49) were more likely to receive anti-obesity pharmacotherapy, p < 0.001 for all comparisons. CONCLUSION: There has been a modest increase in the prevalence of anti-obesity medications in the last 10 years, but they remain significantly underutilized. Further studies addressing the barriers to anti-obesity pharmacotherapy might help in increasing the utilization of these medications among adults with obesity.

Obesity; Weight loss; Morbid obesity; Anti-obesity drugs; Bariatric surgery

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1708-0428 0960-8923

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