Weight Loss Outcomes in a Veterans Affairs Pharmacotherapy-based Weight Management Clinic

Abstract

Context Despite a high prevalence of obesity in the Veteran population, anti-obesity medications (AOMs) have been underutilized in the Veterans Health Administration (VHA). Real world reports on outcomes when AOMs have been used in Veterans is limited. Objective To analyze weight loss outcomes from a local VHA pharmacotherapy-based weight management clinic (WMC) Methods This was a retrospective cohort study of veterans enrolled in a local WMC for 15 months from August 2016 through September 2018 followed through November 2019. Patients were offered one of five available anti-obesity medications (AOM) based on their comorbidities. Factors associated with weight loss (5% or more weight loss) were assessed. Key Results 159 patients were seen in WMC, 149 (93.7%) Veterans were prescribed an anti-obesity medication, 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. Conclusions 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.