Denver—Prescriptions for weight-loss medications are surprisingly uncommon, despite treatment guidelines advocating their use and the availability of FDA-approved therapies.

That’s according to a recent presentation at ENDO 2016, the annual meeting of the Endocrine Society, in Boston.

“We looked at how commonly weight loss medications were prescribed to patients for whom guidelines suggest this treatment would be appropriate,” said lead author Daniel Bessesen, MD, professor of medicine and Chief of Endocrinology at the University of Colorado and Denver Health Medical Center. “It seems that despite the broad realization that obesity is a problem and that there are available FDA approved medications, few patients use this treatment option.”

For the study, researchers used electronic medical records from nine sites from 2009 to 2013, determining that, out of more than 2 million eligible patients, only 1.02% received a weight-loss medication.

Phentermine, which is generic and inexpensive, was the most commonly prescribed at 77.3%, but it is FDA approved for only 3 months of use. Less commonly prescribed were diethypropion, 16.0%, phendimetrazine, 7.4%; and orlistat, 4.5%, according to the research.

In addition, the study found that a small number of medical professionals write the overwhelming majority of the prescriptions for weigh loss medications. Those writing 21 or more prescriptions over the study period accounted for 30.8% of the total pool of prescribing providers, yet they wrote 93.3% of the total number of prescriptions filled. 

The investigation also revealed significant practice variation, with 1.8% of eligible patients receiving a prescription in one system, yet only 0.4% receiving a prescription in another. The number of weight-loss prescriptions filled gradually increased from 37,277 in 2009 to 48,816 in 2013.

Results further indicate that patients were not using the medications continuously because the average fills per patients over the 4 years examined was only 8.9.

“Despite guidelines advocating the use of weight loss medications in obese patients, very few appear to be receiving this treatment option,” study authors conclude.

“In many other diseases like hypertension and diabetes, treatment with medications is common and considered standard practice,” Bessesen added in a press release from The Endocrine Society. “There remain many questions about why so few patients use weight loss medications.”

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