Hardly Any Obese Patients Are Taking Prescription Weight-Loss Pills

Recent research shows that only 1% of obese patients eligible for FDA-approved weight-loss drugs are actually prescribed them.

More than 33% of adults in the United States are currently obese, which means that more than one-third of the US adult population is at risk for related health issues such as coronary artery disease, hypertension, type 2 diabetes, sleep apnea, and other potentially life-threatening conditions.

The estimated annual health care cost of obesity in the United States was $147 billion in 2008, according to the US Centers for Disease Control and Prevention. In addition, obese patients on average face an extra $1429 in annual medical costs compared with patients with a healthy weight.

Obesity ranked highest among US physicians (24.7%) who were asked which conditions they wished had more pharmacological options in a survey conducted by the Social Survey Research Information Company between December 2013 and February 2014. Of note, 5 prescription weight-loss drugs—orlistat (Xenical), lorcaserin (Belviq), phentermine-topiramate (Qsymia), naltrexone-bupropion (Contrave), and liraglutide (Saxenda)— received FDA approval in 2014 or earlier.

More recent research presented at the Endocrine Society’s 2016 Annual Meeting found that a very limited number of health care providers write most of the prescriptions for these weight-loss drugs, suggesting that most providers are either unaware of their availability or don’t consider them to be standard practice yet. Obese patients may also lack awareness of the pharmacological options available to them.

“It seems that despite the broad realization that obesity is a problem and that there are FDA-approved medications, few patients use this treatment option,” concluded lead study author Daniel Bessesen, MD, professor of medicine and chief of endocrinology at the University of Colorado and Denver Health Medical Center, in a press release. “There remain many questions about why so few patients use weight-loss medications.”

As medication experts, pharmacists can help fill in any information gaps that may exist among both prescribers and patients.

Jennifer L. Costello, PharmD, BCPS, BC-ADM, previously told Pharmacy Times that the “risks and benefits [of weight-loss drugs] is an important area for pharmacists to know and review with patients to help educate them on their disease state.”

Awareness of the risks, benefits, and appropriateness of pharmacological treatment may help patients feel empowered to approach their physician about weight-loss medications.

Another potential theory behind the low rates of weight-loss medication prescribing may be that behavioral changes are still the go-to recommendation for obese patients. However, evidence shows that lifestyle changes produce moderate results when implemented alone. Meanwhile, bariatric surgery can be both expensive and risky.

For the current study, researchers analyzed electronic health records from 9 sites across the country from 2009 to 2013 and found that of the 2 million eligible patients, just 1% received an FDA-approved prescription weight-loss drug.