Introduction
Both medication and surgical interventions can be used to treat obesity, yet their
use and effectiveness in routine clinical practice are not clear. This study sought
to characterize the prevalence and management of patients with obesity within a large
U.S. academic medical center.
Methods
All patients aged ≥18 years who were seen in a primary care clinic within the Duke
Health System between 2013 and 2016 were included. Patients were categorized according
to baseline BMI as underweight or normal weight (<25 kg/m2), overweight (25–29.9 kg/m2), Class I obesity (30–34.9 kg/m2), Class II obesity (35–39.9 kg/m2), and Class III obesity (≥40 kg/m2). Baseline characteristics and use of weight loss medication were assessed by BMI
category. Predicted change in BMI was modeled over 3 years. All data were analyzed
between 2017 and 2018.
Results
Of the 173,462 included patients, most were overweight (32%) or obese (40%). Overall,
<1% (n=295) of obese patients were prescribed medication for weight loss or underwent bariatric
surgery within the 3-year study period. Most patients had no change in BMI class (70%)
at 3 years.
Conclusions
Despite a high prevalence of obesity within primary care clinics of a large, U.S.
academic health center, the use of pharmacologic and surgical therapies was low, and
most patients had no weight change over 3 years. This highlights the significant need
for improvement in obesity care at a health system level.
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