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. 2024 Mar;39(4):519-528.
doi: 10.1007/s11606-023-08501-z. Epub 2023 Nov 14.

Real World Use of Anti-Obesity Medications and Weight Change in Veterans

Anna Hung  1   2   3 , Edwin S Wong  4   5 , Paul A Dennis  6   7 , Karen M Stechuchak  6 , Dan V Blalock  6   8 , Valerie A Smith  6   7   9 , Katherine Hoerster  4   5 , Varsha G Vimalananda  10   11 , Susan D Raffa  8   12 , Matthew L Maciejewski  6   7   13   9
Affiliations

Real World Use of Anti-Obesity Medications and Weight Change in Veterans

Anna Hung et al. J Gen Intern Med. 2024 Mar.

Abstract

Background: Anti-obesity medications (AOMs) can be initiated in conjunction with participation in the VA national behavioral weight management program, MOVE!, to help achieve clinically meaningful weight loss.

Objective: To compare weight change between Veterans who used AOM + MOVE! versus MOVE! alone and examine AOM use, duration, and characteristics associated with longer duration of use.

Design: Retrospective cohort study using VA electronic health records.

Participants: Veterans with overweight or obesity who participated in MOVE! from 2008-2017.

Main measures: Weight change from baseline was estimated using marginal structural models up to 24 months after MOVE! initiation. The probability of longer duration of AOM use (≥ 180 days) was estimated via a generalized linear mixed model.

Results: Among MOVE! participants, 8,517 (1.6%) used an AOM within 24 months after MOVE! initiation with a median of 90 days of cumulative supply. AOM + MOVE! users achieved greater weight loss than MOVE! alone users at 6 (3.2% vs. 1.6%, p < 0.001), 12 (3.4% vs. 1.4%, p < 0.001), and 24 months (2.7% vs. 1.5%, p < 0.001), and had a greater probability of achieving ≥ 5% weight loss at 6 (38.8% vs. 26.0%, p < 0.001), 12 (43.1% vs. 28.4%, p < 0.001), and 24 months (40.4% vs. 33.3%, p < 0.001). Veterans were more likely to have ≥ 180 days of supply if they were older, exempt from medication copays, used other medications with significant weight-gain, significant weight-loss, or modest weight-loss side effects, or resided in the West North Central or Pacific regions. Veterans were less likely to have ≥ 180 days of AOM supply if they had diabetes or initiated MOVE! later in the study period.

Conclusions: AOM use following MOVE! initiation was uncommon, and exposure was time-limited. AOM + MOVE! was associated with a higher probability of achieving clinically significant weight loss than MOVE! alone.

Keywords: anti-obesity medication; veteran.; weight change.

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Conflict of interest statement

MLM reports research grants from NIH and VA HSR&D and ownership of Amgen stock due to his spouse’s employment. VAS reports research grants from NIH and VA HSR&D. AH reports research grants from NIH, VA HSR&D, AstraZeneca, and Abbott. All other authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Estimated Mean Weight Loss at 6, 12, 18, and 24 months for AOM + MOVE! versus MOVE! alone
Figure 2
Figure 2
Estimated Probability of Achieving ≥ 5% Weight Loss at 6, 12, 18, and 24 Months for Anti-Obesity Medication Users versus Non-Users
See this image and copyright information in PMC

References

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