Efficacy of Oral Antiobesity Medications With Versus Without Adjunct Behavioral Weight Management Treatment.

Abstract

Guidelines recommend pairing antiobesity medications (AOMs) with behavioral treatment. This 12-week, two-arm randomized controlled trial evaluated oral AOMs with versus without behavioral treatment. We recruited 101 patients eligible for bupropion and naltrexone from a telehealth weight management clinic (WeightWatchers Clinic). Participants were randomized to (i) bupropion and naltrexone (n = 50) or (ii) bupropion and naltrexone with behavioral treatment (WeightWatchers) (n = 51). Remote measurements of body weight, behavioral, and psychosocial measures were completed at baseline and week 12. The primary outcome was the 12-week change in weight (kg). ANCOVA assessed differences in changes between groups. Participants (n = 101) were mostly female (94.1%), average 43.9 years old (SD: 10.7), with a mean BMI of 37.0 kg/m² (SD: 6.3). At 12 weeks, those receiving behavioral treatment lost significantly more absolute and percent weight than those without behavioral treatment (mean difference: -1.8 kg, p = 0.03; mean difference: -1.6%, p = 0.04). Combining oral AOMs with behavioral treatment via telemedicine resulted in significantly greater weight loss than medications alone, supporting the recommendation to pair AOMs with behavioral treatment. ClinicalTrials.gov identifier: NCT06470659.