Ni Kevin, Rogowitz Elisa, Farahmand Abtin K, Kaizer Laura K, Arbet Jaron, Cunningham Christina R, Thomas Elizabeth A, Saxon David R
Division of Endocrinology, Metabolism, and Diabetes, University of Colorado, Aurora, CO 80045, USA.
Division of Endocrinology, Rocky Mountain Regional VA Medical Center, Aurora, CO 80045, USA.
J Endocr Soc. 2024 Mar 6;8(5):bvae042. doi: 10.1210/jendso/bvae042. eCollection 2024 Mar 12.
Despite a high prevalence of obesity in the veteran population, antiobesity medications (AOMs) have been underused in the Veterans Health Administration. Real-world reports on outcomes when AOMs have been used in veterans is limited.
To analyze weight loss outcomes from a local Veterans Health Administration pharmacotherapy-based weight management clinic (WMC).
This was a retrospective cohort study of veterans enrolled in a local WMC for 15 months from August 2016 through September 2018 and followed through November 2019. Patients were offered 1 of 5 available AOMs based on their comorbidities. Factors associated with weight loss (5% or more weight loss) were assessed.
A total of 159 patients were seen in a WMC, 149 (93.7%) veterans were prescribed an AOM, and 129 returned for follow-up. Overall, 61/129 (47%) patients achieved 5% or greater weight loss and 28/129 (22%) achieved 10% or greater weight loss within 15 months. Clinically significant weight loss (%) over the first 15 months was achieved with phentermine/topiramate ER (-6.3%) and liraglutide (-7.5%), but not with orlistat (-3.9%) and lorcaserin (-3.6%). Comorbid obstructive sleep apnea was negatively associated with achieving ≥5% weight loss.
Phentermine/topiramate ER and liraglutide were found to be effective AOMs among veterans. Further work is needed to mitigate barriers to AOM initiation given the continued rise in obesity.
尽管退伍军人中肥胖的患病率很高，但退伍军人健康管理局对减肥药的使用一直不足。关于退伍军人使用减肥药的实际效果报告有限。
分析当地退伍军人健康管理局基于药物治疗的体重管理诊所（WMC）的减肥效果。
这是一项回顾性队列研究，研究对象为2016年8月至2018年9月在当地WMC登记并持续到2019年11月的退伍军人。根据患者的合并症情况，为他们提供5种可用减肥药中的一种。评估与体重减轻（体重减轻5%或更多）相关的因素。
WMC共接待了159名患者，149名（93.7%）退伍军人被开具了减肥药，129名返回进行随访。总体而言，61/129（47%）的患者在15个月内体重减轻了5%或更多，28/129（22%）的患者体重减轻了10%或更多。在最初的15个月里，使用安非他酮/托吡酯缓释剂（-6.3%）和利拉鲁肽（-7.5%）实现了具有临床意义的体重减轻（%），但使用奥利司他（-3.9%）和氯卡色林（-3.6%）则未实现。合并阻塞性睡眠呼吸暂停与体重减轻≥5%呈负相关。
在退伍军人中，安非他酮/托吡酯缓释剂和利拉鲁肽被发现是有效的减肥药。鉴于肥胖率持续上升，需要进一步努力消除开始使用减肥药的障碍。
