Blue Medicine

The Prescription for More Obesity

Environmental Obesity DriversWithout really thinking about it, most everyone assumes obesity is all about diet and exercise. But of course, the causes of obesity are not so simple. We have more obesity today than we did 20 years ago because multiple factors in our environment are triggering more obesity in people who are biologically susceptible. One of those factors is the drugs that health professionals prescribe for us. In fact, a new study in Obesity tells us that fully one in five adults are taking prescription medicines that can contribute to obesity.

Data from NHANES, 1999 to 2018

Craig Hales and colleagues analyzed data from NHANES on 52,340 persons from 1999 through 2018. They found that 20.3 percent of adults in 2018 were taking a prescription medicine that could cause weight gain. That’s up from 13.2 percent in 2000 – a 54 percent increase.

This increase happened because people are taking more medicines – not because providers are becoming more likely to favor a drug that causes weight gain. The proportion of prescribed drugs that could cause gain remained constant over this time period. The focus here was on beta blockers and  medicines for seizures, depression, diabetes, inflammation, and psychosis. Just a bit more than half of the total prescriptions in this group of drugs were for specific ones that could cause weight gain.

Ironically, the most common prescriptions that could cause weight gain were for diabetes and heart disease. These are conditions where excess weight contributes to the problem.

Good News and Bad News in Trends

Looking at the trends in specific drug classes, there’s good news and bad news. The good news is that prescribers are more often avoiding antidiabetics, beta blockers, and antidepressants that cause weight gain. But for seizures, the trend favors drugs that cause weight gain. In prescribing for inflammation and psychosis, relative prescribing of obesogenic drugs has not changed.

The trend away from obesity-promoting drugs for diabetes is especially good news. Somehow it seems bizarre to treat a disease that often results from obesity with drugs that can cause obesity.

We wonder if that would happen so easily if more doctors thought of obesity as a medical condition rather than a personal issue.

Click here for the Hales study, here, here, and here for more on medicines that cause weight gain.

Blue Medicine, drawing by Bill Rogers, licensed under CC BY-NC-ND 2.0

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January 22, 2022