Antiobesity Medication Added to Workplace Weight Management Program Effective in Real-world Setting

Adults with obesity who participated in a real-world, employer-based weight-management program (WMP) were significantly more likely to achieve clinically meaningful weight loss when antiobesity medication (AOM) was added to the regimen, according to a recent study published in JAMA Network Open.

“The research results support the need to treat patients with a multidisciplinary weight management program that incorporates safe and effective medications to lose weight and maintain weight loss,” said primary investigator Bartolome Burguera, MD, PhD, chair of the Cleveland Clinic Endocrinology and Metabolism Institute, in a press release. “Doctors prescribe medications to treat some of the health consequences associated with obesity, such as hypertension and type 2 diabetes. However, medications for weight loss and chronic weight management are underutilized.”

To determine the effect of combining AOMs with a multidisciplinary employer-based WMP, researchers analyzed data from 200 adults with obesity (88.5% women; mean age=50 years; mean baseline weight=105 kg) who were enrolled in the Cleveland Clinic Employee Health Plan between January 2019 and May 2020.

Participants were randomized 1:1 to either a WMP combined with an AOM (n=100) or to a WMP alone (n=100).

The WMP was administered through monthly shared medical appointments (SMAs) that focused on adopting a healthier lifestyle and addressed the 5 components of the WMP:

  • Nutrition
  • Physical activity
  • Appetite control
  • Sleep issues
  • Anxiety, depression, and/or stress

Due to the COVID-19 pandemic, however, some of the SMAs were conducted virtually, researchers noted.

Participants in the WMP plus AOM cohort received 1 of 5 medications approved by the Food and Drug Administration for chronic weight management: orlistat, lorcaserin, phentermine/topiramate, naltrexone/bupropion, liraglutide 3.0 mg, based on recommended clinical practice.

Lorcaserin was withdrawn from the market in February 2020, so the 8 participants who were taking it as the time were notified immediately and either switched or discontinued AOM use due to proximity to the end of the study.

The primary endpoint was the percentage change in body weight from baseline to 12 months.

For the primary intention-to-treat estimand, the estimated mean weight loss was -7.7% for those in the WMP plus AOM cohort compared with -4.2% for those in the WMP alone, with an estimated treatment difference of -3.5% (95% confidence interval, -5.5% to -1.5%; P<.001).

The estimated percentage of participants achieving at least 5% weight loss was 62.5% for the WMP plus AOM group compared to 44.8% for the WMP alone group (P=.02), according to the study.

Compared to participants who did not receive AOMs, those in the WMP plus AOM cohort had a higher SMA attendance.

Researchers did not observe any meaningful differences in patient-reported work productivity or limitation measures.

“Further research is needed regarding the economic effect of access to AOMs in real-world, employer-based settings, considering employee performance and function, medication costs, and reduction in other obesity-related medical costs,” concluded study authors.