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Treatment of Obesity: Pharmacotherapy Trends of Office-Based Visits in the United States From 2011 to 2016

Published:October 30, 2021DOI:



      To examine pharmacotherapy for obesity in the United States from 2011 to 2016 using a large, nationally representative sample.


      Data were obtained during 6 years, 2011 to 2016, from the National Ambulatory Medical Care Survey. There were 3 types of visits identified: patients with obesity and an antiobesity drug mention; patients with obesity and no antiobesity drug mention; and patients without obesity and with antiobesity drug mention. The χ2 test was used to compare characteristics across each type of visit. To predict the odds of an antiobesity medication mention for patients with obesity, a logistic regression analysis was conducted.


      Of the overall weighted 196,872,870 office-based physician visits made by patients with obesity from 2011 to 2016, 1% mentioned an antiobesity drug. In addition, there were 760,470 office-based physician visits by patients without obesity but with an antiobesity medication mention. An antiobesity drug mention was more likely for those aged 51 years or older and those residing in the South (adjusted odds ratio, 5.31 95% CI, 1.19 to 23.59).


      There was a slight increase in antiobesity medication mentions, from 0.26% in 2011 to 0.28% in 2016, but only 1% of office-based visits for patients with obesity received a prescription for an antiobesity medication. Physicians tended to prescribe antiobesity medications to those with obesity aged 51 years or older and residing in the South. Antiobesity medication for treatment of obesity is significantly underused.

      Abbreviations and Acronyms:

      AMA (American Medical Association), AOR (adjusted odds ratio), BMI (body mass index), FDA (US Food and Drug Administration), ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification), ICD-10-CM (International Classification of Diseases, Tenth Revision, Clinical Modification), NAMCS (National Ambulatory Medical Care Survey), NCHS (National Center for Health Statistics), NHAMCS (National Hospital Ambulatory Medical Care Survey)
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        • Centers for Disease Control and Prevention
        Adult obesity facts.
        Date: 2021
        Date accessed: February 13, 2021
        • Ward Z.J.
        • Bleich S.N.
        • Cradock A.L.
        • et al.
        Projected U.S. state-level prevalence of adult obesity and severe obesity.
        N Engl J Med. 2019; 381: 2440-2450
        • Xia Y.
        • Kelton C.M.
        • Guo J.J.
        • Bian B.
        • Heaton P.C.
        Treatment of obesity: pharmacotherapy trends in the United States from 1999 to 2010.
        Obesity (Silver Spring). 2015; 23: 1721-1728
        • Thomas C.E.
        • Mauer E.A.
        • Shukla A.P.
        • Rathi S.
        • Aronne L.J.
        Low adoption of weight loss medications: A comparison of prescribing patterns of antiobesity pharmacotherapies and SGLT2s.
        Obesity (Silver Spring). 2016; 24: 1955-1961
        • Bessesen D.H.
        • Van Gaal L.F.
        Progress and challenges in anti-obesity pharmacotherapy.
        Lancet Diabetes Endocrinol. 2018; 6: 237-248
      1. Recognition of Obesity as a Disease. American Medical Association, 2013 (Resolution: 421(A-13))
        • Apovian C.M.
        • Aronne L.J.
        • Bessesen D.H.
        • et al.
        Pharmacological management of obesity: an Endocrine Society clinical practice guideline [erratum appears in J Clin Endocrinol Metab. 2015;100(5):2135-2136].
        J Clin Endocrinol Metab. 2015; 100: 342-362
        • Lee M.
        • Lauren B.N.
        • Zhan T.
        • et al.
        The cost-effectiveness of pharmacotherapy and lifestyle intervention in the treatment of obesity.
        Obes Sci Pract. 2020; 6: 162-170
        • Jannah N.
        • Hild J.
        • Gallagher C.
        • Dietz W.
        Coverage for obesity prevention and treatment services: analysis of Medicaid and state employee health insurance programs.
        Obesity (Silver Spring). 2018; 26: 1834-1840
        • Gomez G.
        • Stanford F.C.
        US health policy and prescription drug coverage of FDA-approved medications for the treatment of obesity.
        Int J Obes (Lond). 2018; 42: 495-500
        • Jensen M.D.
        • Ryan D.H.
        • Apovian C.M.
        • et al.
        2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society [erratum appears in Circulation. 2014;129(25, suppl 2):S139-S140].
        Circulation. 2014; 129: S102-S138
        • Heymsfield S.B.
        • Wadden T.A.
        Mechanisms, pathophysiology, and management of obesity.
        N Engl J Med. 2017; 376: 254-266
        • Wilding J.P.H.
        • Batterham R.L.
        • Calanna S.
        • et al.
        Once-weekly semaglutide in adults with overweight or obesity.
        N Engl J Med. 2021; 384: 989
        • LeBlanc E.S.
        • Patnode C.D.
        • Webber E.M.
        • Redmond N.
        • Rushkin M.
        • O'Connor E.A.
        Behavioral and pharmacotherapy weight loss interventions to prevent obesity-related morbidity and mortality in adults: updated evidence report and systematic review for the US Preventive Services Task Force.
        JAMA. 2018; 320: 1172-1191
        • Patel D.K.
        • Stanford F.C.
        Safety and tolerability of new-generation anti-obesity medications: a narrative review.
        Postgrad Med. 2018; 130: 173-182
        • Srivastava G.
        • Apovian C.M.
        Current pharmacotherapy for obesity.
        Nat Rev Endocrinol. 2018; 14: 12-24
        • Centers for Disease Control and Prevention
        2016 NAMCS micro-data file documentation.
        • National Center for Health Statistics
        Ambulatory health care data.
        Date accessed: February 21, 2021
        • Lau D.T.
        • Strashny A.
        • Phan K.
        • Blum A.L.
        • Burke-Bebee S.
        Evaluation of transition from ICD-9-CM to ICD-10-CM diagnosis coding system in the National Ambulatory Medical Care Survey.
        Natl Health Stat Rep. 2018; 120: 1-10
        • National Center for Health Statistics
        Survey methods and analytic guidelines.
        Date accessed: February 21, 2021
        • Elangovan A.
        • Shah R.
        • Smith Z.L.
        Pharmacotherapy for obesity—trends using a population level national database.
        Obes Surg. 2021; 31: 1105-1112
        • Saxon D.R.
        • Iwamoto S.J.
        • Mettenbrink C.J.
        • et al.
        Antiobesity medication use in 2.2 million adults across eight large health care organizations: 2009-2015.
        Obesity (Silver Spring). 2019; 27: 1975-1981
        • Pachankis J.E.
        • Hatzenbuehler M.L.
        • Wang K.
        • et al.
        The burden of stigma on health and well-being: a taxonomy of concealment, course, disruptiveness, aesthetics, origin, and peril across 93 stigmas.
        Pers Soc Psychol Bull. 2018; 44: 451-474
        • Foster G.D.
        • Wadden T.A.
        • Makris A.P.
        • et al.
        Primary care physicians’ attitudes about obesity and its treatment.
        Obes Res. 2003; 11: 1168-1177
        • Phelan S.M.
        • Burgess D.J.
        • Yeazel M.W.
        • Hellerstedt W.L.
        • Griffin J.M.
        • van Ryn M.
        Impact of weight bias and stigma on quality of care and outcomes for patients with obesity.
        Obes Rev. 2015; 16: 319-326
        • Persky S.
        • Eccleston C.P.
        Medical student bias and care recommendations for an obese versus non-obese virtual patient.
        Int J Obes (Lond). 2011; 35: 728-735
        • Puhl R.
        • Brownell K.D.
        Bias, discrimination, and obesity.
        Obes Res. 2001; 9: 788-805
        • Tomiyama A.J.
        • Finch L.E.
        • Belsky A.C.
        • et al.
        Weight bias in 2001 versus 2013: contradictory attitudes among obesity researchers and health professionals.
        Obesity (Silver Spring). 2015; 23: 46-53
        • Onakpoya I.J.
        • Heneghan C.J.
        • Aronson J.K.
        Post-marketing withdrawal of anti-obesity medicinal products because of adverse drug reactions: a systematic review.
        BMC Med. 2016; 14: 191