Study: Antiobesity Drugs Are Underused

A retrospective study finds that physicians are failing to treat overweight individuals with antiobesity medications that could mitigate these patients' risk of developing diabetes.

Seeking to characterize the adoption of antiobesity pharmacotherapies compared with that of the newest antidiabetes pharmacotherapy, subtype 2 sodium-glucose transport protein inhibitors (SGLT2s), among prescribers in the United States, researchers conducted a retrospective analysis of 2012 to 2015 data extracted from the IMS Health National Prescription Audit and Xponent to assess adoption rates of antiobesity pharmacotherapies and SGLT2s.
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Overall, the authors found the number of dispensed antidiabetes prescriptions was 15 times greater than that of dispensed antiobesity prescriptions. The antiobesity market share was 74% phentermine and 18.6% new antiobesity pharmacotherapies. The mean increase in prescriptions per month was 25,259 for SGLT2s, 5154 for new antiobesity pharmacotherapies, and 2718 for phentermine. Medical specialties prescribing the majority of the analysis medications were family medicine/general practice, and internal medicine/endocrinology had the highest prevalence of prescribers of any subspecialty, according to the investigators. 

While noting that the underprescribing of antiobesity pharmacotherapies is widely acknowledged, the authors point out that this is the first prescription data of these new medications to demonstrate its extent in the United States.

"Disease prevalence statistics tells us that significant proportions of primary care practitioners' patients are overweight and pre-diabetic or at risk for developing diabetes," said Catherine E. Thomas, MS, a clinical researcher at Weill Cornell Medical College and lead author of the study.

"There are safe and effective treatments that can reduce weight and improve insulin resistance, thus mitigating the risk for diabetes and its complications," Thomas said, adding that these findings signify that training in obesity medicine is "likely key in achieving appropriate utilization of the available FDA-approved anti-obesity pharmacotherapies." 

For some primary care physicians, "a viable option will be to become certified by the American Board of Obesity Medicine, which is the fastest growing medical specialty in the United States, and an option for others is to refer patients to ABOM-certified physicians," she said. "Trained practitioners can effectively utilize the available 6 FDA-approved antiobesity pharmacotherapies with indicated patients who have not had success with a reduced calorie diet and exercise regimen."

—Mark McGraw

Thomas CE, Mauer EA, Shukla AP, Rathi S, Aronne LJ. Low adoption of weight loss medications: a comparison of prescribing patterns of antiobesity pharmacotherapies and SGLT2s [published online September 2016]. Obesity. doi:10.1002/oby.21533.