Trends in Use of Obesity Medications and Metabolic and Bariatric Surgery Among All of Us Participants From 2003 to 2023.

Abstract

This study aimed to evaluate the trends in antiobesity medication (AOM) and metabolic and bariatric surgery (MBS) use relative to the 2013 American Medical Association (AMA) declaration of obesity as a chronic disease and semaglutide approval in 2021 in the United States. We employed a repeated cross-sectional design to analyze national electronic health records (EHR) of US adults (≥ 18 years) with obesity (BMI ≥ 30 kg/m²) or overweight (BMI ≥ 27 kg/m²) with ≥ 1 comorbidity for AOM and those with BMI ≥ 35 kg/m² for MBS, using the All of Us dataset. We used interrupted time-series models to evaluate trends from January 1, 2003, to October 1, 2023. AOM rates increased by 0.31%/year (95% CI, 0.25%, 0.37%) after 2013 and further increased by 1.42%/year (95% CI, 1.16%, 1.68%) after 2021. MBS use declined by 0.10%/year (95% CI, -0.15%, -0.04%) before 2013. Semaglutide approval was not associated with MBS use decline after 2021. After 2013, patients with BMI ≥ 40 kg/m² experienced a larger increase in AOM use (0.50% [95% CI, 0.40%, 0.61%]) vs. < 40 kg/m² (0.25%/year [95% CI, 0.20%, 0.30%]) and stable MBS use. The declaration increased AOM use and, to a lesser extent, MBS use. Semaglutide approval increased AOM use but had no impact on MBS use.