Abbinaya Elangovan1, Raj Shah2, Zachary L Smith3,4. 1. Department of Internal Medicine-Pediatrics, MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA. 2. Division of Gastroenterology and Liver Disease, University Hospitals, Case Western Reserve University School of Medicine, Cleveland, OH, USA. 3. Division of Gastroenterology and Liver Disease, University Hospitals, Case Western Reserve University School of Medicine, Cleveland, OH, USA. zsmith@mcw.edu. 4. Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Hub for Collaborative Medicine, 8701 Watertown Plank Rd, Milwaukee, WI, 53226, USA. zsmith@mcw.edu.
Abstract
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/m2), 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.
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/m2), 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.
Entities:
Keywords:
Anti-obesity drugs; Bariatric surgery; Morbid obesity; Obesity; Weight loss
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