August 29, 2019
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Weight loss improves with prompt obesity medication use

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Incorporating an obesity medication regimen into a weight loss program can help adults with obesity reduce weight more effectively than nonpharmacologic approaches, especially if patients start taking the medications early, according to findings published in Obesity Science and Practice.

“Obesity continues to be treated as a lifestyle choice by far too many physicians when, in fact, it is a medical condition that must be holistically managed,” Rami Bailony, MD, co-founder and CEO of Enara Health in San Mateo, California, told Endocrine Today. “Our research provides one more piece of the puzzle when it comes to unlocking the complexity of obesity, and it serves as a reminder to physicians that we must work together to destigmatize obesity itself.”

Bailony and colleagues conducted a retrospective study of 129 adults (mean age, 45 years; 67% women) with a BMI of at least 30 kg/m2 (mean BMI, 37 kg/m2) who took part in a weight loss program from Enara Health. The program involved consistent interaction with health care providers as well as the use of a mobile app to enhance the process. Researchers collected data from Enara Health records on body weight measures at baseline, 24 months, 48 months and 72 months. In addition, electronic health records were used to confirm use of obesity medications, such as lorcaserin, phendimetrazine, diethylpropion, phentermine, liraglutide and bupropion/naltrexone.

Seventy-one participants had at least 1 month of medication use and qualified as medication users. These users lost 14% of their original weight at 72 weeks, whereas those who did not use such medications lost 10.9% of their original weight (P = .008). Medication users reduced their absolute weight by a mean 15 kg at 72 weeks, whereas nonusers reduced their absolute weight by a mean 10.4 kg (P < .001). Sixty-nine percent of medication users lost at least 10% of their original weight by the 72-week mark, whereas 50% of nonusers met this threshold (P = .03). At the study’s conclusion, 45.1% of medication users lost at least 15% of their body weight vs. 19% of nonusers (P < .001).

 
Incorporating an obesity medication regimen into a weight loss program can help adults with obesity reduce weight more effectively than nonpharmacologic approaches, especially if patients start taking the medications early.
Source: Shutterstock

EHRs also provided information on when participants began using their prescribed medications and how long they used them. Participants who began taking medications before completing 2 months of the weight loss program lost 17.6% of their original weight, whereas those who began taking medications after 2 months lost 14% (P = .024). Participants who began taking medications earlier lost 19.7 kg of absolute weight, and those who began taking them later lost 14.1 kg of absolute weight (P = .003). Almost three-quarters of those termed “early users” lost at least 15% of their original weight (72.3%), whereas 42.9% of participants who delayed medication use reached this threshold (P = .019). The researchers further observed that participants who took their medications for 6 months or more lost 17.3 kg of absolute weight and that those who had less than 6 months of medication use lost 11.8 kg of absolute weight (P = .019).

“Physicians may want to re-evaluate the common notion that weight-loss medication is only to be explored when patients have failed to achieve a certain amount of weight loss via lifestyle modification,” Bailony said. “We found that earlier administration of such medication within a program can provide a significant and sustained boost to success.”

Medication use alone may not have yielded these results, which surpassed those of other studies, according to Bailony.

“We also uncovered some surprising insights when it came to the importance of the larger digital health program itself,” Bailony said. “Basically, we found that using digital health to optimize medications can triple the success rate.” – by Phil Neuffer

For more information: Rami Bailony, MD, can be reached at rami@enarahealth.com.

Disclosures: Bailony reports that he is the co-founder and CEO of Enara Health, which funded this study.