75% of Doctors Rarely or Never Prescribe Obesity Drugs

Obesity is a widespread epidemic in the United States, affecting 42.4 percent of Americans in 2018 ( 1 ). This condition is defined by an excess of body fat that causes a body mass index reading of 30 or higher. Without obesity treatment, the disease can lead to several other severe medical conditions, including diabetes, heart disease, stroke, and more.

Although obesity affects such a significant percentage of our population, many eligible patients aren’t prescribed obesity drugs that could help them. A recent study by David R. Saxon, MD, assessed prescription behaviors in more than two million Americans for six years ( 2 ). Saxon is an endocrinologist at the University of Colorado in Aurora.

What Did the Study Find?

Saxon and his team conducted their study from 2009 to 2015. They assessed health care records of over two million Americans across eight health care organizations to learn more about how often anti-obesity medications are prescribed and how often patients were filling them.

The study found that only 1.3 percent of eligible patients for obesity drugs actually received them. A quarter of physicians included in the study were responsible for 90 percent of the obesity prescriptions filed. It can be concluded that approximately 75 percent of physicians studied rarely or never prescribed obesity drugs, even to eligible patients.

Another interesting finding is that 75 percent of prescriptions for obesity drugs were for phentermine, even though there are five different obesity drugs that have been approved by the FDA ( 3 ). These include orlistat, lorcaserin, naltrexone/bupropion, and liraglutide.

Why Aren’t Doctors Prescribing Obesity Drugs?

Despite the widespread nature of obesity in the United States, there are several reasons why doctors aren’t prescribing weight loss drugs:

1. Many people in the U.S. do not think of obesity as a serious condition. Currently, many people think of obesity as something that the patient can control with changes to diet and exercise. However, there are many cases in which obesity is out of the patient’s control and cannot be treated with behavioral approaches. These patients could benefit significantly from prescription obesity medication.

A switch in mindset could help increase the rate of obesity prescriptions and potentially reduce the rate of health complications resulting from obesity. This would encourage doctors to prescribe anti-obesity medication more often, and also encourage patients to take their obesity seriously and ask for treatment as needed.

2. Providers aren’t always trained to identify and treat obesity problems correctly. Due to this lack of training, obesity may not be correctly noted in a patient’s records, and doctors aren’t motivated to prescribe anti-obesity drugs that could be effective.

3. Patients aren’t educated about obesity. Many patients do not know that obesity drugs are an option for safe weight loss treatment, so they do not ask for them. Patients also may be hesitant to take obesity drugs because of their cost. Not all insurance companies cover the cost of obesity treatments, which can deter patients from taking them even if they get a prescription.

What Are the Benefits of Obesity Drugs?

Even if a patient can lose weight with changes to their diet and exercise regimen, anti-obesity drugs can speed up the process and enable them to reach a healthy weight faster.

Phentermine, which is the most commonly prescribed weight loss medication in the United States, suppresses appetite and boosts energy. Other weight-loss drugs use different mechanisms to help patients lose weight. For example, orlistat prevents the body from absorbing fat, while Lorcaserin affects how the brain processes serotonin, making patients feel full.

Although the result is similar, these drugs work in very different ways. Some people, therefore, may benefit from one weight loss drug but experience acute side effects with another. For an effective weight loss treatment, doctors and other healthcare providers need to understand how these drugs work. They should also not shy away from trying new approaches to treat obesity.

Conclusion

Diet and exercise are essential for treating obesity, but it just isn’t enough for many patients. Saxon’s study has shown that doctors dramatically underprescribe obesity drugs. With such high obesity rates in the U.S., a new approach will be necessary to tackle overall health and wellbeing.