Empty Glass

Is This Progress in Use of Anti-Obesity Medicines?

Eight years have passed since the American Medical Association decided obesity really is a complex chronic disease. For treating this disease, we have more options now. We have a handful of anti-obesity medicines that are new. A new study in Obesity Surgery tells us their use has more than doubled over the last decade.

So is this good news? Is our glass half full? Or mostly empty? More than double means that 2.9 percent of adults with obesity received a prescription for an anti-obesity medicine in 2019. Thats up from 1.1 percent in 2010.

In other words, 97 percent of people who might benefit from one of these drugs are not getting a prescription. Compare this to diabetes, for which 88 percent of patients use oral meds, insulin, or both.

So it’s fair to say the the glass is still mostly empty for the use of anti-obesity medicines.

A Deep Dive into Electronic Health Records

These data come from electronic health records for more than 12 million U.S. adults with obesity. Abbinaya Elangovan, Raj Shah, and Zachary Smith analyzed a decade of data from the IBM Watson Health Explorys platform. This system aggregates data on 64 million patients in 26 health networks and more than 350 hospitals across the U.S.

Elangovan et al found interesting patterns in the who were more or less likely to utilize these meds. Women, people under 50, and African Americans were more likely to get a prescription. Hispanics were less likely. People with commercial insurance were the most likely to get a prescription. Medicare patients were the least likely. They also looked at the use of these meds in people within five years of getting a gastric sleeve. Among these patients, 3.5 percent received a new prescription for an anti-obesity medicine after their surgery.

A Gap in Care

Obesity Care OptionsThis study reminds us that the state of obesity care is both encouraging and sad. It is encouraging because we have good options that can make a big difference in the lives and health of people with obesity. What’s more, we can see progress in the number of people getting evidence-based care.

But that progress is also pathetically slow. Even more discouraging is that most people with obesity are left with only two rather poor options: do-it-yourself or weight loss scams. The billions of dollars that people spend on scams is a clue that people need more access to effective options.

Elangovan et al sum it up:

“The ongoing increase in the rates of obesity in the US is currently poorly matched by parallel rates of antiobesity pharmacotherapy, both as a primary and adjunctive intervention. The emergence of new medications in the past decade has been associated with an upward trend in the widespread usage of anti-obesity pharmacotherapy; however, these medications continued to be vastly underutilized.”

This will change. But only if we keep advocating for the needs of people living with obesity.

Click here for the study, here and here for further perspective.

Empty Glass, photograph © Ted Kyle / flickr

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March 13, 2021