Abstract
PURPOSE: Nearly 90% of individuals with type 2 diabetes mellitus (T2DM) are either overweight or obese, placing them at high risk of microvascular and macrovascular complications. The main objective of this study was to assess the use of antiobesity medications and antihyperglycemic agents that produce weight gain among patients with T2DM who qualify for National Institutes of Health guideline-recommended pharmacologic weight loss therapy.
METHODS: This study used the 2005-2006 through 2015-2016 biannual cycles of the National Health and Nutrition Examination Survey and included adults aged ≥20 years who reported a diagnosis of T2DM and who qualified for antiobesity treatment (defined as a body mass index ≥27 kg/m
FINDINGS: Among adults with T2DM who qualified for antiobesity treatment (N = 2910), only 40 participants (2.2%; 95% CI, 1.5-3.3) were on pharmacologic antiobesity treatment within 30 days of survey interview. The only antiobesity medications identified were liraglutide (n = 34 [1.9%]), phentermine (n = 4 [0.2%]), orlistat (n = 1 [0.1%]), and phentermine/topiramate (n = 1 [0.0%]). Among those who were on antihyperglycemic treatment (n = 2401), 1661 (66%; 95% CI, 63.1-68.8) were on weight-inducing antihyperglycemic agents; however, a downward trend in the use of these agents over time was observed (from 78.4% in 2005-2006 to 53.3% in 2015-2016; P < 0.0005).
IMPLICATIONS: This is the first national epidemiologic study evaluating the use of antiobesity medications and weight-inducing antihyperglycemic agents among patients with T2DM who qualify for weight loss therapy. This study documents that patients are not on guideline-directed weight loss therapy. Furthermore, weight loss goals are likely compromised by 66% of individuals being on weight-inducing antihyperglycemic therapy. Use of antiobesity medications could play a significant role in promoting weight loss and potentially lead to a healthier lifestyle, which could reduce microvascular and macrovascular complications. Stronger recommendations in using guideline-directed therapy in obesity complicated by T2DM are necessary.
| Original language | American English |
|---|---|
| Pages (from-to) | e35-e44 |
| Journal | Clinical Therapeutics |
| Volume | 44 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 1 2022 |
Bibliographical note
Publisher Copyright:© 2022 Elsevier Ltd
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. All authors have made substantial contributions to all of the following: (1) the conception and design of the study, or acquisition of data, or analysis and interpretation of data; (2) drafting the article or revising it critically for important intellectual content; and (3) final approval of the version to be submitted. The authors have indicated that they have no conflicts of interest regarding the content of this article.
ASJC Scopus Subject Areas
- Pharmacology
- Pharmacology (medical)
Keywords
- United States
- adult
- anti-obesity agents
- diabetes mellitus
- humans
- hypoglycemic agents
- liraglutide
- nutrition surveys
- obesity
- orlistat
- phentermine
- prevalence
- topiramate
- type 2
- weight loss
- Obesity
- Weight loss
- Pharmacoepidemiology
- Diet therapy
- Diabetes Mellitus, Type 2
- Drug therapy
Disciplines
- Medicine and Health Sciences
- Pharmacy and Pharmaceutical Sciences
- Pharmacology, Toxicology and Environmental Health
- Medical Pharmacology