Anti-obesity drugs - are they underused in the United States?

Abstract

INTRODUCTION: Obesity is a major risk factor for coronary heart disease. We analysed the use of anti-obesity drugs in the United States in recent years. METHODS: We included 5332 (2630 men and 2702 women) participants of the National Health and Nutrition Examination Survey 2007-2008. We studied their demographic data, body mass index (BMI), and their weight and drug histories. Candidates were eligible for anti-obesity drugs if their BMI > 30.0 kg/m2, or BMI > 27.0 kg/m2 in the presence of one or more risk factors (hypertension, diabetes or dyslipidemia). RESULTS: 45.9% men and 45.0% women were eligible to take anti-obesity drugs. Although 85.1% knew they were overweight and 90.1% desired to lose weight, only 0.6% were on drugs during the previous month. 0.5% were on phentermine and 0.1% on orlistat. None were on sibutramine. During the preceding year, 2.2% took prescription drugs and 3.7% took nonprescription drugs to control weight. Furthermore, among eligible participants, only 61.9% changed their diet and 36.5% exercised to control weight. CONCLUSIONS: Although obesity is highly prevalent, anti-obesity drug use was very low in the United States. This indicates that the withdrawal of sibutramine in 2010 would not have a large impact. More widespread changes in lifestyle are needed. Anti-obesity drugs should be considered for those who do not respond to lifestyle changes alone.