Weight Loss After Receiving Anti-Obesity Medications and Gout Among Individuals With Overweight and Obese: A Population-Based Cohort Study

Objective

Weight loss is conditionally recommended for gout management; however, its impact on incident gout and recurrent gout flares among individuals who were overweight and obese remains unknown. We investigate the relationship between weight loss rate following treatment with anti-obesity medications and the risk of incident gout and recurrent gout flares among individuals who were overweight or obese.

Methods

Using data from the Health Improvement Network, we selected individuals aged 18 and older who were overweight or obese and started anti-obesity medication. We emulated a target trial to examine the association of different weight loss rates, slow (2%–5%), moderate (5%–10%), or fast (≥10%), within the first year of treatment with incident gout and recurrent gout flares during a 5 year follow-up period.

Results

Among 131,000 participants without gout being treated with orlistat, the 5-year risk of incident gout was 1.6% for those with weight gain or stability, compared with 1.5%, 1.3%, and 1.2% for those with slow, moderate, and fast weight loss, respectively. Compared with the group with weight gain or stability, the hazard ratios were 0.91 (95% confidence interval [CI] 0.81–1.01), 0.82 (95% CI 0.72–0.92), and 0.73 (95% CI 0.62–0.86) for those with a slow, moderate, and fast rate of weight loss, respectively. Similar results were observed for the recurrent gout flares among 3,847 individuals with overweight or obese with gout treated with orlistat.

Conclusion

A higher rate of weight loss after receiving treatment with orlistat within 1 year was associated with lower risks of incident gout and lower rates of recurrent gout flares among overweight or obese people.