Conference Coverage: Highlights from ObesityWeek 2023

ObesityWeek, the preeminent international conference dedicated to the latest developments in evidence-based obesity science, wrapped up last week. Standout presentations and posters included late-breaking data from the SURMOUNT-3 research program on tirzepatide and major predictors of weight regain following the completion of a weight management program. Below is more detailed information about these and other newsworthy studies.

Does insurance provider influence anti-obesity treatment persistence?

Authors of a retrospective cohort study of patients who filled at least one prescription for an anti-obesity medication (AOM) between 2015 and 2022 found a link between the continued use of AOM and the type of health care plan carried by the patient.

Dr. Hamlet Gasoyan, Ph.D., a health services researcher at the Cleveland Clinic Center for Value-Based Care Research, and his team studied electronic health records and Surescripts dispensed prescription data of obese adult patients in the Cleveland Clinic health system who filled an initial prescription for either a glucagon-like peptide-1 receptor agonist (GLP-1 RA) or an AOM. Most of the patients were women (58%) and Caucasian (71%).

When compared to privately insured individuals, patients with Medicaid and Medicare were more likely to discontinue use of AOM. Among privately insured patients, the specific insurance carrier was associated with the odds of treatment persistence. Non-persistence also resulted from limitations in insurance coverage, certain precertification criteria, and the type of AOM or GLP-1 RA prescribed. Researchers concluded that a better understanding of the determinants of later stage persistence, such as amount of weight lost within the first several months, could help address the barriers with early-stage non-persistence. Read more

Antidepressant use does not negatively impact weight loss benefit from semaglutide

In this post-hoc analysis of the Semaglutide Treatment Effect in People with Obesity (STEP) program, Robert Kushner, MD, and his colleagues found that adults who took antidepressants while using semaglutide achieved a similarly significant weight loss to individuals not taking antidepressants.

Researchers analyzed data from a total of 3,683 participants, 539 of which were on antidepressants. These individuals were randomly assigned to either semaglutide or a placebo plus a lifestyle intervention or intensive behavioral therapy. Patients were excluded if they had an active major depressive disorder.

Antidepressants did not blunt the effect of semaglutide for weight loss, suggesting that the anti-obesity medication is an effective treatment option for weight management, regardless of antidepressant use. Read more

Tirzepatide leads to substantial weight loss, even after weight loss from lifestyle change

Results from the phase three SURMOUNT-3 trial show that tirzepatide demonstrated clinically meaningful additional weight loss in adults with obesity who had already had at least a 5% weight loss after an intensive, 12-week lifestyle intervention. Researchers presented their findings at ObesityWeek on the same day that their study was published in the journal Nature.

SURMOUNT-3 enrolled 806 obese or overweight individuals with at least one weight-related comorbidity; individuals with diabetes were excluded. Participants received 12 weeks of an intensive lifestyle intervention, consisting of eight counseling sessions about diet and exercise plus behavior modification strategies. Following this, the 579 individuals who achieved ≥5% weight reduction were randomized to receive either tirzepatide or placebo for the following 72 weeks.

The co-primary endpoint of greater percent change in weight from randomization to 72 weeks was met (a loss of 18.4% with tirzepatide vs. a gain of 2.5% with placebo). The other co-primary endpoint, the percentage of participants achieving additional weight reduction ≥5%, was also met (87.5% of patients receiving tirzepatide vs. 16.5% of patients receiving placebo), suggesting that trizepatide is a powerful tool for ongoing weight loss management. Read more

What factors predict weight loss maintenance after completing weight management plan?

This study identified behavioral, psychological, and environmental predictors of weight regain and continued weight maintenance among 2,843 individuals who were already successful at long-term weight loss in WeightWatchers.

At the beginning of the study and one year later, participants replied to several questionnaires that asked about predictors of weight loss maintenance. Over the year of follow-up, 43% gained ≥2.3 kg and 57% maintained their weight. Those who maintained their weight reported more consistent monitoring of their diet and weight, a greater acceptance of uncomfortable food cravings, and a reduced tendency to overeat when faced with food cues. Those who gained over the year were younger in age and had higher initial weight, more recent weight losses, and larger weight losses. Gainers also reported worsening body image, body satisfaction, and bodily pain.

The findings suggest the importance of imparting coping skills to aid with food cravings, to teach how to self-monitor diet, and to accept one’s body. Read more