Prevalence of Antiobesity Treatment and Weight-Inducing Antihyperglycemic Agents Among Patients With Type 2 Diabetes in the United States

Purpose: Nearly 90% of individuals with type 2 diabetes mellitus (T2DM) are either overweight or obese, placing them at high risk of microvascular and macrovascular complications. The main objective of this study was to assess the use of antiobesity medications and antihyperglycemic agents that produce weight gain among patients with T2DM who qualify for National Institutes of Health guideline- recommended pharmacologic weight loss therapy. Methods: This study used the 2005-2006 through 2015-2016 biannual cycles of the National Health and Nutrition Examination Survey and included adults aged >= 20 years who reported a diagnosis of T2DM and who qualified for antiobesity treatment (defined as a body mass index >= 27 kg/m(2)) at the time of physical examination. Antiobesity medication use was defined as use of orlistat, phentermine, diethylpropion, lorcaserin, phentermine/topiramate, bupropion/naltrexone, or liraglutide. Use of weight-inducing antihyperglycemic agents was defined as use of sulfonylureas, thiazolidinediones, or insulin (any type), either alone or in combination with any other antihyperglycemic agent regardless of effect on weight. Findings: Among adults with T2DM who qualified for antiobesity treatment (N = 2910), only 40 participants (2.2%; 95% CI, 1.5-3.3) were on pharmacologic antiobesity treatment within 30 days of survey interview. The only antiobesity medications identified were liraglutide (n = 34 [1.9%]), phentermine (n = 4 [0.2%]), orlistat (n = 1 [0.1%]), and phentermine/topiramate (n = 1 [0.0%]). Among those who were on antihyperglycemic treatment (n = 2401), 1661 (66%; 95% CI, 63.1-68.8) were on weight-inducing antihyperglycemic agents; however, a downward trend in the use of these agents over time was observed (from 78.4% in 2005-2006 to 53.3% in 2015-2016; P < 0.0005). (C) 2022 Elsevier Inc.