Background

The purpose of this study was to determine the indications for anti-obesity medications (AOM) in patients at our multidisciplinary weight loss clinic.

Methods

A retrospective chart review at a single academic bariatric surgery center was performed.

Results

153 patients were prescribed AOM from 2017-2022. Mean age and BMI at the time of initial visit was 44.7 years and 45.0 kg/m2. 53 (34.6%) patients received preoperative AOM for primary bariatric surgery, 40 (26.1%) for weight stall after primary bariatric surgery, 30 (19.6%) for weight regain after primary bariatric surgery, 17 (11.1%) for preoperative weight loss in revisional surgery, and 13 (8.5%) for weight regain after revisional surgery. The weight regain after revisional surgery group required the most AOMs (mean 3.5, range 1-7), followed by the preoperative primary surgery group (mean 2.3, range 1-8), weight stall group (mean 2.1, range 1-6), preoperative revision group (mean 2.1, range 1-4), and the weight regain after primary surgery group (mean 1.9, range 1-5). AOM regimens were frequently prescribed for 3-month intervals due to insurance requirements or clinical response of the drug. AOMs prescribed were: phentermine (50.4%), topiramate (19.5%), Saxenda (12.8%), and other (17.2%). Across all indications, adverse drug reactions occurred in 34 out of 343 (9.9%) AOM regimens: ineffectiveness (2.6%), insomnia (2.3%), fatigue/fogginess (1.5%), nausea (1.5%), mood changes (1.2%).

Conclusions

AOM were prescribed for five indications in our study: preoperative weight loss for primary and revisional bariatric surgery, weight regain following primary and revisional bariatric surgery, and weight stall after primary bariatric surgery.