Jay Pendse1,2,3, Franco Vallejo-García1,2,3, Andrew Parziale1,2,3, Mae Callanan4, Craig Tenner4, José O Alemán1,2,3. 1. Division of Endocrinology, Department of Medicine, Manhattan Campus of the VA New York Harbor Healthcare System, New York, New York, USA. 2. Division of Endocrinology, Department of Medicine, New York University Langone Medical Center, New York, New York, USA. 3. Laboratory of Translational Obesity Research, New York University Grossman School of Medicine, New York, New York, USA. 4. Department of Medicine, Manhattan Campus of the VA New York Harbor Healthcare System, New York, New York, USA.
Abstract
OBJECTIVE: Obesity is a major public health challenge, and the US military veteran population is disproportionately affected. Using deidentified records from a local weight management clinic and a national clinical data repository, obesity pharmacotherapy use and effectiveness for weight loss and obesity comorbidities in this vulnerable population were assessed. METHODS: During the initial year of the local clinic, 43 records with monthly follow-up of MOVE! lifestyle intervention augmented by obesity pharmacotherapy were found. Nationally, more than 2 million records of prescribed obesity pharmacotherapy compared with metformin as control were identified. Records with detailed documentation of weight trends from 1 year before to 1 year after the prescription date for further analysis were selected for review. RESULTS: The most commonly prescribed medications in the local clinic were metformin, liraglutide, and combination phentermine/topiramate. On average, weight loss of -4.0 ± 2.1 kg over the initial 6-month intervention was observed. In the national cohort, 577,491 records with an obesity or control metformin prescription and adequate weight documentation were identified. The most effective pharmacotherapy in the national cohort was phentermine/topiramate (-0.0931 ± 0.0198 kg/wk difference), followed by liraglutide, lorcaserin, and orlistat. CONCLUSIONS: Obesity pharmacotherapy is effective in achieving clinically meaningful weight loss in veterans as part of an integrated care approach. Published 2021. This article is a U.S. Government work and is in the public domain in the USA.
OBJECTIVE: Obesity is a major public health challenge, and the US military veteran population is disproportionately affected. Using deidentified records from a local weight management clinic and a national clinical data repository, obesity pharmacotherapy use and effectiveness for weight loss and obesity comorbidities in this vulnerable population were assessed. METHODS: During the initial year of the local clinic, 43 records with monthly follow-up of MOVE! lifestyle intervention augmented by obesity pharmacotherapy were found. Nationally, more than 2 million records of prescribed obesity pharmacotherapy compared with metformin as control were identified. Records with detailed documentation of weight trends from 1 year before to 1 year after the prescription date for further analysis were selected for review. RESULTS: The most commonly prescribed medications in the local clinic were metformin, liraglutide, and combination phentermine/topiramate. On average, weight loss of -4.0 ± 2.1 kg over the initial 6-month intervention was observed. In the national cohort, 577,491 records with an obesity or control metformin prescription and adequate weight documentation were identified. The most effective pharmacotherapy in the national cohort was phentermine/topiramate (-0.0931 ± 0.0198 kg/wk difference), followed by liraglutide, lorcaserin, and orlistat. CONCLUSIONS: Obesity pharmacotherapy is effective in achieving clinically meaningful weight loss in veterans as part of an integrated care approach. Published 2021. This article is a U.S. Government work and is in the public domain in the USA.
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