Efficacy of Anti-Obesity Medications in Adult and Older Adult Veteran Populations.

Abstract

Background: Treatment options for obesity have previously focused on lifestyle modifications, including diet, exercise, and surgery. More recently, anti-obesity medications (AOMs), such as semaglutide, liraglutide, phentermine/topiramate, bupropion/naltrexone, and orlistat, have been shown to be effective for both weight loss and improving cardiometabolic risk factors. However, no data exist comparing the efficacy of AOMs in differing age groups.

Methods: The primary endpoint for this study was the percent change in body weight from baseline compared to 6 and 12 months after AOM initiation in adults (aged < 65 years) vs older adults (aged ≥ 65 years). Secondary endpoints included changes in low-density lipoprotein (LDL), hemoglobin A_1c (HbA_1c) in patients diagnosed with diabetes or prediabetes at baseline, and blood pressure at 12 months from baseline. Safety endpoints recorded the incidence of adverse events (AEs) and AOM discontinuation.

Results: Between January 1, 2021, and June 30, 2023, a total of 116 adults and 28 older adults at the Veterans Affairs Sioux Falls Health Care System were prescribed an AOM and included in the study. There was no significant difference in percent change in body weight at 6 months (P = .08) or 12 months (P = .26) between adults and older adults. HbA_1c (P = .73) and LDL (P = .95) levels showed no statistically significant difference between age groups, nor did systolic (P = .55) and diastolic (P = .51) blood pressure. More AEs were reported (61% vs 39%), and increased discontinuation of therapy due to AEs (6% vs 0%) was noted in the adult group compared with the older adult group.

Conclusions: AOMs may have similar outcomes for weight loss in patients of all ages and similar metabolic results between adults aged < 65 years and older adults aged ≥ 65 years. Adults may experience more AEs when compared with older adults.