2097-P: Weight Loss Maintenance in Medically Managed Patients with Obesity

• Published in: Diabetes (New York, N.Y.) Vol. 68; no. Supplement_1
• Main Authors: TCHANG, BEVERLY G., ARAS, MOHINI, MANDEL, LINDSAY, IGEL, LEON I., KUMAR, REKHA, SAUNDERS, KATHERINE H., WAITMAN, JONATHAN, ARONNE, LOUIS, SHUKLA, ALPANA
• Format: Journal Article
• Language: English
• Published: New York American Diabetes Association 01-06-2019
• Subjects: Body weight loss; Clinical trials; Demography; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Drug therapy; Metformin; Obesity; Statistical analysis; Topiramate; Weight control
• DOI: 10.2337/db19-2097-P
• EISSN: 1939-327X
• ISSN: 0012-1797

Background: The efficacy of anti-obesity medications in combination with lifestyle modification is robustly supported by randomized controlled trials, but there is a paucity of data on their effectiveness for weight loss maintenance in clinical practice.
Objectives: To investigate real-world effectiveness of anti-obesity medications (AOM) to maintain weight loss over 2 years.
Methods: A retrospective chart review of patients who established care at an academic weight management center between 4/2014-4/2016 was performed by three independent reviewers. Patients who had both 1-year and 2-year follow-up appointments were identified. Demographics, medications, and weight changes after pharmacotherapy initiation were recorded during 2-year follow-up.
Results: Of 1775 new patients, 883 met eligibility criteria, and 423 patients had weight data recorded at 1-year and 2-year time points. Patients were 74.2% female with an average age of 50.9 + 13.8 years, and 17.0% had type 2 diabetes (T2DM). The mean baseline weight and BMI were 98.6 + 22.5 kg and 35.3 + 6.87 kg/m2, respectively. The mean weight loss at year-1 and year-2 was similar (-9.9 + 7.7% vs. -10.3 + 8.8%, p=0.31). There was no statistically significant difference in weight loss between the T2DM and non-DM cohorts at 2 years (-8.69% vs. -10.48%, p=0.12). The average BMI change at 2 years was -10.7 + 9.4% (p<0.001). Seventy-five percent of patients achieved ≥ 5% weight loss at 1 year, and of these, 87.4% maintained that loss at 2 years. Forty-six percent of patients achieved ≥10% weight loss at 1 year, of which 76.9% maintained that loss at 2 years. At 2 years, 96.2% of patients remained on > 1 weight loss medication with an average of 2.4 + 1.2 drugs. The most commonly prescribed weight-loss pharmacotherapies were metformin (71.5%), phentermine (23.3%) and topiramate (19.9%).
Conclusions: Clinically significant weight loss maintenance over 2 years is achievable with the use of multi-drug weight-loss pharmacotherapy in a specialty care center.
Disclosure
B.G. Tchang: None. M. Aras: None. L. Mandel: None. L.I. Igel: None. R. Kumar: Speaker's Bureau; Self; Janssen Pharmaceuticals, Inc., Novo Nordisk Inc. Stock/Shareholder; Self; VIVUS, Inc., Zafgen, Inc. K.H. Saunders: None. J. Waitman: None. L. Aronne: Advisory Panel; Self; Eisai Inc., Gelesis, Jamieson Wellness Inc., Janssen Pharmaceuticals, Inc., Novo Nordisk Inc., Pfizer Inc., Real Appeal, Inc., UnitedHealth Group Inc. Board Member; Self; BMIQ Professionals Program, Jamieson Wellness Inc., MYOS Corp. Consultant; Self; Eisai Inc., Gelesis, Jamieson Wellness Inc., Janssen Pharmaceuticals, Inc., Novo Nordisk Inc., Real Appeal, Inc., UnitedHealth Group Inc. Research Support; Self; Allurion, Aspire Bariatrics, AstraZeneca, Eisai Inc., Janssen Pharmaceuticals, Inc., Novo Nordisk Inc. Stock/Shareholder; Self; BMIQ Professionals Program, ERX Pharmaceuticals, Inc., Gelesis, Jamieson Wellness Inc., MYOS Corp, Zafgen, Inc. A. Shukla: None.