Willingness to Take Weight Loss Medication Among Obese Primary Care Patients

In contrast, lower QOL scores, especially in the domains of self-esteem and sex life, were associated with increased willingness to take a weight loss medication and appeared to be a stronger predictor than individual comorbidities. This is consistent with other studies showing that patients seeking treatment for obesity tend to have lower health-related QOL [9,17]. Our findings are also consistent with our previous research demonstrating that impairments in specific QOL domains are often more important to patients and stronger drivers of diminished well-being than measures of overall QOL [18]. Hence, given their importance to patients, clinicians need to consider QOL benefits when counseling patients about the risks and benefits of various obesity treatments.

This study is the first to our knowledge to systematically characterize demographic factors associated with the likelihood of primary care patients with obesity considering weight loss pharmacotherapy. This information may aid outpatient weight loss counseling by increasing awareness of gender and patient specific preferences. The fact that many patients with obesity appear to be interested in pursuing weight loss medication may also support public health initiatives in providing equitable access to weight loss pharmacotherapy. As our study characterizes patients who are willing to pursue weight loss medications, future studies may include retrospective analyses on actual use of weight loss medications among various demographic groups. Further investigation on specific reasons why patients choose whether or not to use weight loss medication may also be helpful.

This study has important limitations. The sample size was modest and potentially underpowered to detect small differences across different subgroups. Our sample was also limited to practices in Boston, which limits generalizability; although, by design, we oversampled racial and ethnic subjects to ensure diverse representation. Finally, our study examined patients’ hypothetical willingness to take weight loss medications rather than their actual adherence to treatment if offered.

Conclusion

In this sample of obese primary care patients, we found that the majority of patients were willing to take a daily medication to lose weight; however, patients had expectations for weight loss that far exceeded the level achievable by patients in pharmaceutical trials of these agents. Men and patients with diabetes were more likely to be willing to pursue weight loss medication; however, lower weight-related QOL, especially low self-esteem and impaired sexual function, appeared to be a stronger correlate of willingness to consider pharmacotherapy than comorbid diagnoses.

Corresponding author: Christina C. Wee, MD, MPH, Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA 02215, cwee@bidmc.harvard.edu.

Funding/support: This study was funded by the National Institute of Diabetes, Digestive and Kidney Diseases (R01 DK073302, PI Wee). Dr. Wee is also supported by an NIH midcareer mentorship award (K24DK087932). The sponsor had no role in the design or conduct of the study; the collection, management, analysis, and interpretation of the data; or the preparation, review, or approval of the manuscript.

Financial disclosures: None reported.