Antiobesity Medication Use Among Overweight and Obese Adults in the United States: 2015-2018

Endocr Pract. 2021 Nov;27(11):1139-1148. doi: 10.1016/j.eprac.2021.07.004. Epub 2021 Jul 12.

Abstract

Objective: To estimate the utilization of U.S. Food and Drug Administration- approved prescription antiobesity medications (AOMs) and to identify factors associated with AOM use in the United States.

Methods: Respondents aged ≥18 years meeting AOM eligibility criteria in the 2015-2016 and 2017-2018 National Health and Nutrition Examination Survey and the 2016 Medical Expenditure Panel Survey were included in the study. AOM eligibility was defined as having a body mass index (BMI) of ≥30 kg/m2 or having a BMI between 27 and 29.9 kg/m2 and at least 1 obesity-related comorbidity. Demographic, socioeconomic, and clinical characteristics, economic outcomes, and health-related quality of life were summarized and compared between AOM users and nonusers. Multivariable logistic regression was used to identify factors that were associated with AOM use.

Results: Only 0.80% of eligible adults reported using AOMs in the past 30 days in 2015-2016 and 2017-2018 National Health and Nutrition Examination Survey. A greater proportion of current AOM users previously tried dietary changes compared with nonusers. They also reported an average weight loss of 3.1 kg over the previous year compared with a 1.5-kg gain among the nonusers. The total health care costs trended higher among AOM users, driven mostly by higher outpatient service costs. A BMI of ≥30 kg/m2, depression, dyslipidemia, and infertility predicted AOM use, whereas Medicare and being at risk of sleep apnea were associated with lower odds of AOM use.

Conclusion: Despite the availability of newer AOMs and their inclusion in medical treatment guidelines, the utilization of AOMs remains low. This may reflect under-prescribing of and/or restricted patient access to approved evidence-based pharmacotherapy for obesity.

Keywords: antiobesity medication; obesity; overweight; weight loss drugs.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Humans
  • Medicare*
  • Nutrition Surveys
  • Obesity / complications
  • Obesity / drug therapy
  • Obesity / epidemiology
  • Overweight / drug therapy
  • Overweight / epidemiology
  • Quality of Life*
  • United States / epidemiology