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. 2019 Dec;27(12):1975-1981.
doi: 10.1002/oby.22581. Epub 2019 Oct 11.

Antiobesity Medication Use in 2.2 Million Adults Across Eight Large Health Care Organizations: 2009-2015

David R Saxon  1   2 , Sean J Iwamoto  1   2 , Christie J Mettenbrink  3 , Emily McCormick  3 , David Arterburn  4 , Matthew F Daley  5 , Caryn E Oshiro  6 , Corinna Koebnick  7 , Michael Horberg  8 , Deborah R Young  8 , Daniel H Bessesen  1   3
Affiliations

Antiobesity Medication Use in 2.2 Million Adults Across Eight Large Health Care Organizations: 2009-2015

David R Saxon et al. Obesity (Silver Spring). 2019 Dec.

Abstract

Objective: The aim of this study was to examine the prescribing patterns and use of antiobesity medications in a large cohort of patients using data from electronic health records.

Methods: Pharmacy- and patient-level electronic health record data were obtained on 2,248,407 adults eligible for weight-loss medications from eight geographically dispersed health care organizations.

Results: A total of 29,964 patients (1.3% of total cohort) filled at least one weight-loss medication prescription. This cohort was 82.3% female, with median age 44.9 years and median BMI 37.2 kg/m2 . Phentermine accounted for 76.6% of all prescriptions, with 51.7% of prescriptions being filled for ≥ 120 days and 33.8% filled for ≥ 360 days. There was an increase of 32.9% in medication days for all medications in 2015 compared with 2009. Higher prescription rates were observed in women, black patients, and patients in higher BMI classes. Of 3,919 providers who wrote at least one filled prescription, 23.8% (n = 863) were "frequent prescribers" who wrote 89.6% of all filled prescriptions.

Conclusions: Weight-loss medications are rarely prescribed to eligible patients. Phentermine accounted for > 75% of all medication days, with a majority of patients filling it for more than 4 months. Less than one-quarter of prescribing providers accounted for approximately 90% of all prescriptions.

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Conflict of interest statement

Disclosure: None of the authors has any potential conflicts of interest to disclose.

Figures

Figure 1
Figure 1. Weight Loss Medication Prescriptions by Sex, BMI, and Race/Ethnicity.
Percentage of eligible patients who received a weight loss medication prescription by (A) gender, (B) BMI (kg/m2), and (C) race/ethnicity. AIAN, American Indian or Alaskan Native. NHPI, Native Hawaiian or Pacific Islander.
Figure 2
Figure 2. Temporal Trends in Medication Days by Medication Type
During 2009–2015 the total number of weight loss medication days increased due to an increase in the amount of phentermine prescribed.
Figure 3
Figure 3
Phentermine Treatment Duration (N = 25,637 Patients)
See this image and copyright information in PMC

Comment in

  • The Obesity (Under) Treatment Conundrum.
    Dietz WH. Dietz WH. Obesity (Silver Spring). 2019 Dec;27(12):1928-1929. doi: 10.1002/oby.22641. Epub 2019 Nov 6. Obesity (Silver Spring). 2019. PMID: 31696629 No abstract available.

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