Veterans Affairs San Diego Healthcare System, San Diego, California, USA.
Division of Gastroenterology, University of California, San Diego, California, USA.
Obesity (Silver Spring). 2019 May;27(5):716-723. doi: 10.1002/oby.22444.
This study aimed to evaluate a possible association between the use of obesogenic medications and inadequate weight loss in a behavioral weight-management program.
This is a case-control, single-center study of 666 adult patients within a Veterans Health Administration health system who participated in the MOVE! behavioral weight-loss program. The cohort was divided into responders (n = 150), patients who achieved ≥ 5% total weight loss by the end of the MOVE! program, and nonresponders (n = 516), those who achieved < 5% total weight loss. We reviewed each patient's medical records for exposure to obesogenic medication during the time of treatment.
Approximately 62% (n = 411) of patients entering MOVE! had a prescription for obesogenic medications. Obesogenic medication use was associated with worse weight-loss outcomes, and participants were 37% less likely to achieve a clinically meaningful (≥ 5% total weight loss) outcome at the end of the MOVE! program (odds ratio, 0.633; 95% CI: 0.427-0.937; adjusted P = 0.022). Patients who received three or more medications (n = 72) had the greatest difficulty achieving 5% weight loss compared with the control group (odds ratio, 0.265; 95% CI: 0.108-0.646; adjusted P = 0.003).
The use of provider-prescribed obesogenic medications was associated with worse weight-loss outcomes in a behavioral weight-loss program. Closer scrutiny of patient medications is necessary to help improve outcomes of weight-loss treatments.
本研究旨在评估在行为体重管理计划中使用致肥胖药物与体重减轻不足之间可能存在的关联。
这是一项单中心病例对照研究，纳入了退伍军人健康管理系统内参与 MOVE!行为减重计划的 666 名成年患者。该队列分为应答者（n=150）和无应答者（n=516）。应答者为 MOVE!计划结束时体重减轻≥5%的患者，无应答者为体重减轻<5%的患者。我们回顾了每位患者在治疗期间使用致肥胖药物的病历。
约 62%（n=411）进入 MOVE!的患者有处方致肥胖药物。致肥胖药物的使用与较差的减重结果相关，参与者在 MOVE!计划结束时达到临床有意义（≥5%的总体重减轻）结果的可能性降低了 37%（优势比，0.633；95%置信区间：0.427-0.937；调整后 P=0.022）。与对照组相比，接受三种或更多药物（n=72）的患者达到 5%体重减轻的难度最大（优势比，0.265；95%置信区间：0.108-0.646；调整后 P=0.003）。
在行为体重减轻计划中，使用提供者开的致肥胖药物与减重结果较差相关。需要更仔细地检查患者的药物，以帮助改善减重治疗的结果。
