Review of Pharmacologic Weight Loss Medications in a Patient-Centered Medical Home

Background: Per the Centers for Disease Control, 78 million adults were classified as obese in the United States in 2009 to 2010. Lifestyle modifications and pharmacologic treatment are appropriate options to combat obesity. Objectives: The primary objective of the study was to assess change in body weight after 12 weeks in patients seen at a family medicine patient-centered medical home (PCMH) who were prescribed Food and Drug Administration-approved weight loss medications. Methods: A retrospective medical record review was used to evaluate weight loss in adult patients with office visits at the PCMH. Adult patients were eligible for inclusion in the study if prescribed a Food and Drug Administration approved weight loss medication between July 1, 2013, and March 31, 2014, and had at least one weight documented during a follow-up visit 12 weeks after the initial prescription. Results: Of the 27 patients identified for study inclusion, 22 (81.5%) were prescribed phentermine. The remaining 5 (18.5%) patients were prescribed phentermine/topiramate ER. After 12 weeks of pharmacologic therapy, the median change in body weight was -3.7 kg (range = -16.8 to 5.5 kg) regardless of medication taken. This correlates to a -1.4 kg/m² (range = -15.7 to 4.2 kg/m²) median change in body mass index. Twelve patients (44.4%) lost at least 5% of their body weight during the study period. Conclusions: In our study population, we observed a median weight loss of 3.7 kg over 12 weeks while utilizing weight loss medications. Unfortunately, other lifestyle-modification services offered through the PCMH were not consistently utilized.