Patient Characteristics Associated with Receipt of Prescription Weight‐Management Medications Among Veterans Participating in MOVE!

Abstract

Objective: Weight-management medications (WMM) are recommended for the treatment of obesity. This study examined characteristics associated with initial receipt of WMM among eligible veterans in the first year following enrollment in the Veterans Health Administration (VHA) MOVE! behavioral weight-management program. Methods: We conducted a retrospective cohort study of VHA patients with obesity or overweight and obesity-related comorbidities who enrolled in MOVE! from October 2013 to September 2016 (N =153,939). Multivariable logistic regression models estimated predictors of having a filled prescription for WMM and for orlistat. Results: A total of 1.1% of these veterans received WMM. The most common WMM included orlistat (70.4%), phentermine/topiramate (11.2%), and bupropion/naltrexone (9.7%). Female sex, higher BMI, obstructive sleep apnea, osteoarthritis, depression, lower back pain, and alcohol abuse were associated with greater odds of use of WMM, whereas age over 65 years, Hispanic ethnicity, and required co-payments were associated with lower odds. Among patients receiving WMM, older age, black race, female sex, higher BMI, cardiovascular disease, lower back pain, and congestive heart failure were associated with use of orlistat versus any other WMM. Conclusions: Of patients engaged in MOVE! in the VHA, 1.1% received WMM. WMM are underutilized among veterans. Additional research is needed to understand barriers to incorporating WMM into comprehensive obesity treatment plans.

Obesity Pharmacotherapy is Effective in the Veterans Affairs Patient Population: A Local and Virtual Cohort Study

“…Similarly, in a retrospective cohort study done between 2013 and 2016, Thomas and colleagues showed that 1.1% of VA patients ( N = 153,939) eligible for an antiobesity medication through the MOVE! program received it (17). A likely reason for the low rates of use is that most weight management medications require prior approval before dispensing.…”

Testing a self-directed lifestyle intervention among veterans: The D-ELITE pragmatic clinical trial

“…We expect low participation rates in other weight loss programs, dietitian services, and weight loss medication prescriptions as was found in E-LITE [16], and given few Veterans participate in MOVE! [9], receive dietitian care [43], and/or are prescribed weight loss medications [44].…”

Using Medicine to Manage a Chronic Disease

“…Antiobesity medications are valuable clinical tools that can help in managing this complex chronic disease. The study by Thomas et al suggests that health care professionals and the public need a better understanding of obesity as a disease and a better understanding of how these medications can help some patients achieve better long‐term health outcomes.…”

“…Six years after the American Medical Association recognized obesity as a complex chronic disease , progress continues toward more effectively managing it as one. New research from Thomas et al in this issue of Obesity suggests once again that some of the tools that we have for obesity care are barely being used. Their study examined the use of weight management medications among more than 153,000 patients with obesity or with overweight and obesity‐related comorbidities who enrolled in the Veterans Health Administration's MOVE!…”