Antiobesity medication use across the veterans health administration: patient-level predictors of receipt.

Abstract

Pharmacotherapy is an effective adjunct to behavioral interventions to treat obesity; although it is unclear how often medications are integrated into obesity treatment plans and for which patients in the Veterans Health Administration (VHA). A retrospective cohort study was conducted that examined variation in and predictors of antiobesity medication receipt (orlistat) among > 2 million obese Veterans within 140 facilities nationwide. One-percent of all obese patients using VHA services filled a prescription for orlistat. Veterans were more likely to be treated with orlistat if they had a higher BMI, were female, unmarried, younger, a minority, had home instability, prescribed obesogenic psychiatric medications, had a psychiatric or obesity-related comorbidity, and used MOVE! weight management services. Among those who likely met the criteria for use, 2.5% had at least one orlistat prescription. Facility-level prescription rates varied from 0 to 1% of all obese patients in a VA facility receiving a prescription and 0 to 21% among those who met the criteria for use. Consistent with guidelines recommending that obesity pharmacotherapy be prescribed in conjunction with behavioral therapy, the strongest predictor of receiving orlistat was being enrolled in the MOVE! weight-loss management program.