Use of medications associated with weight change among participants in the All of Us research programme

Abstract

Our objective was to describe the use of medications associated with weight change among US adults with overweight/obesity, including anti-obesity medications (AOMs), weight-loss-promoting and weight-gain-promoting medications. We performed a cross-sectional analysis of data from the nationwide All of Us Research Programme. We included adults with measured body mass index (BMI) ≥ 27 kg/m² enrolled between 2018 and 2022 across the United States. We used linked electronic health record data to determine medication use ±12 months of BMI measure. Our 132 057 participants had mean age 54 years and mean BMI 34 kg/m² ; 60% of participants were women, 62% White, and 32% Black. Only 1% used any AOM, and 14% used at least one weight-loss-promoting medication. We found that 36% used at least one weight-gain-promoting medication, and approximately 20% used multiple weight-gain-promoting medications. While AOMs are underutilized by participants with overweight/obesity, weight-gain-promoting medication use is common. Our results raise concern about potential iatrogenic weight gain from medications. Future research is needed to estimate the long-term effect of weight-gain-promoting medications on weight status and determine whether weight-loss benefits occur with their discontinuation. Clinician education on AOMs and weight-loss-promoting medications may be needed to increase their use.

Keywords: anti-obesity agents; body weight changes; drug side effects; obesity.

Figure 1.. Weight-Loss-Promoting Medication Use among Included Participants in the All of Us Research Program.

Among adults with BMI ≥ 27 kg/m², we report the count of all weight-loss-promoting medications identified in the electronic health record within ± 12 months of weight measurement. Upper limit was defined as a count of ≥ 3 weight-loss-promoting medications (excluding anti-obesity medications).

Figure 2.. Weight-Gain-Promoting Medication Use among Included Participants in the All of Us Research Program.

Among adults with BMI ≥ 27 kg/m², we report the count of all weight-gain-promoting medications identified in the electronic health record within ± 12 months of weight measurement. Upper limit was defined as a count of ≥ 4 weight-gain-promoting medications.