Prescribing Patterns That Promote Weight Gain

Headline writers are fond these days of depicting a “craze” among prescription writers for new obesity medicines. But in fact, it seems that long-standing prescribing patterns may promote more weight gain than weight loss. A new paper by Erik Almazan, Jessica Schwartz, and Kimberly Gudzune documents prescribing for medicines that promote weight gain in 36 percent of patients with overweight and obesity. In sharp contrast, only one percent of those patients received an anti-obesity medicine. Only 14 percent used any medicine that might cause weight loss.

Indeed, it seems that prescribing patterns favor weight gain more than weight loss.

From the All of Us Study

These data come from the All of Us research program. In this NIH program, researchers have assembled health and demographic data from diverse people all over the U.S. to learn how biology, lifestyle, and environment affect health. The people in the present dataset had an average BMI of 34 and an average age of 54. The total sample size was 132,057 individuals, all of whom enrolled between 2018 and 2022.

This paper complements a study from Craig Hales and colleagues, who also found the use of medicines that promote weight gain is quite common. They looked at a sample of the whole adult population in the U.S. from NHANES – not just people with overweight and obesity. About 20 percent of this population was using such medications.

Prescribing Obesity or Obesity Treatment?

So this begs a question. Is it the prescribing of anti-obesity medicines that is excessive? Or should pharmacy benefit mangers put a tad more energy into discouragement of prescribing medicines that promote weight gain?

Click here for the Almazan study and here for the Hales study.

Pharmacie Caenevet, photograph by Velvet, licensed under CC BY-SA 3.0

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August 14, 2023