Holtrop Jodi Summers, Tietbohl Caroline, Perreault Leigh, Connelly Lauri, Smith Peter C, Williams Johnny
Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.
Adult and Child Center for Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.
Front Med (Lausanne). 2025 Jul 7;12:1584799. doi: 10.3389/fmed.2025.1584799. eCollection 2025.
Obesity is a prevalent and concerning chronic condition; however, evidence-based interventions are available for treatment. With the arrival of newer and more effective anti-obesity medications, questions emerge regarding how these medicines can and should be used and how they affect the practice of primary care medicine. The objective of this study was to examine the many and intersecting factors affecting use and impact of these medicines.
Qualitative study of interviews with primary care practice members and their patients in one Colorado health system ( = 56 practices) over 3 years. Thematic analysis was used to triangulate responses from patients and practice members.
Key themes from both practice members and patients were highly consistent revealing the following categories of benefits and burdens: (1) the new medicines are a "game changer" for practice and changed lives for patients, (2) there is significant burden for all in obtaining the medications for many patients, (3) not all patients should be on the medications, (4) the medications have changed the conceptualization of obesity for patients and providers, and practice teams, and (5) the availability of these medications have changed the practice of treating obesity in important ways. It was further identified that a cascade of events involving various factors with a "right fit" between the patient, provider, and other factors were needed to make way for access to and effective use of these medications.
The arrival of highly effective weight loss medications may invigorate efforts to integrate weight management into primary care, but the implications of this shift are still unknown. Further exploration of the long-term effects on patients, providers and care paradigms is warranted.
肥胖是一种普遍且令人担忧的慢性疾病；然而，有基于证据的干预措施可用于治疗。随着更新、更有效的抗肥胖药物的出现，关于这些药物如何能够且应该被使用以及它们如何影响初级保健医学实践的问题也随之出现。本研究的目的是探讨影响这些药物使用和效果的诸多相互交织的因素。
对科罗拉多州一个医疗系统（共56个医疗机构）的初级保健机构成员及其患者进行了为期3年的定性访谈研究。采用主题分析法对患者和机构成员的回答进行三角验证。
机构成员和患者的关键主题高度一致，揭示了以下几类益处和负担：（1）新药对医疗实践而言是“改变游戏规则者”，并改变了患者的生活；（2）为许多患者获取药物对所有人来说都有很大负担；（3）并非所有患者都适合使用这些药物；（4）这些药物改变了患者、医疗服务提供者以及医疗团队对肥胖的认知；（5）这些药物的可获得性在重要方面改变了肥胖治疗的实践。进一步发现，需要一系列涉及各种因素且患者、医疗服务提供者及其他因素之间“匹配得当”的事件，才能为获取和有效使用这些药物创造条件。
高效减肥药物的出现可能会推动将体重管理纳入初级保健的努力，但这种转变的影响仍不明确。有必要进一步探索其对患者、医疗服务提供者和护理模式的长期影响。
