PSUN113 Evaluating The Efficacy Of Anti-Obesity Medications In a Multidisciplinary Weight Management Clinic At a VA Medical Center

Abstract

Abstract Objective Anti-obesity medications have been shown to be effective in multiple randomized clinical trials, but there is limited data on the efficacy of these medications in the veteran population. This study was aimed to evaluate the effectiveness of anti-obesity medications in a multidisciplinary weight management clinic at our VA medical center. Methods This was a retrospective, descriptive study of 98 patients seen in a multidisciplinary weight management clinic at our VA medical center between January 1, 2019 and October 31, 2021. General requirements to be seen in the clinic were a BMI >30 or BMI >27 with comorbid conditions. Patients seen at least twice in the clinic were included in the study. Patients who received anti-obesity medications (phentermine-topiramate, naltrexone-bupropion, or GLP-1 receptor agonist (liraglutide or semaglutide)) had weights recorded at medication start date and at 2-4 months, 4-8 months, 8-10 months, and 10-14 months intervals. Baseline BMI, HbA1c, LDL-C and triglycerides were recorded at the medication start and followed up at similar intervals. Results There were 98 participants (56% males) within this study, with mean age of 54.9 years, mean baseline weight of 127.3 kg, and BMI of 43.5. Of all 98 patients seen in the clinic (regardless of being on anti-obesity medicine), 85 experienced some weight loss with 39 losing at least 5% of their body weight. The average weight loss from first to last visit was 4.1%. There were 72 patients who received anti-obesity medications for at least 3 consecutive months, including 12 patients who were subsequently trialed on a second class of anti-obesity medication. There were 35 trials of Qsymia, 43 trials of GLP-1 receptor agonists, and 6 trials of naltrexone-bupropion. For those patients receiving medications, average weight loss at 2-4 months was 3.7% (N=73), 4-8 months was 4.9% (N=58), 8-10 months was 6.0% (N=32), and 10-14 months was 5.5% (N=29). The percentage of patients able to lose at least 5.0% of their weight was 30.1% at 2-4 months, 43.1% at 4-8 months, 68.8% at 8-10 months, and 51.7% at 10-14 months. There was a decrease noted in HbA1c and LDL-C at all time periods, while there was no change in triglycerides. Conclusion Our data shows the effectiveness of anti-obesity medications in a veteran population seen in a multidisciplinary weight management clinic, though to a lesser extent as compared to clinical trials. Given the higher prevalence of multiple chronic conditions seen in veterans when compared to the general population, these patients have additional challenges when trying to achieve their weight loss goals. Further study must be performed to determine the long-term effectiveness and tolerability of these medications in this population. The differential effects among the anti-obesity medications should also be investigated further. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.