Correlates of Obesity Medication Use in Paediatric Weight Management Programmes: A POWER Consortium Analysis

Area of Science:

• Pediatric Endocrinology
• Clinical Pharmacology
• Public Health

Background:

• The national Pediatric Weight Management REgistry (POWER) shows rising use of obesity medications (ObM) in youth.
• Factors influencing ObM prescribing patterns remain unclear.
• Understanding these factors is crucial for optimizing treatment strategies.

Purpose of the Study:

• To compare clinical characteristics of youth prescribed ObMs versus those not.
• To analyze prescribing patterns of ObMs across different pediatric weight management programs.
• To identify key determinants of ObM initiation in adolescent obesity care.

Main Methods:

• Analysis of data from 4,628 youth (ages 6-18) across 12 POWER sites (2018-2024).
• Comparison of clinical and demographic variables between ObM and non-ObM groups using logistic regression.
• Assessment of site-level prescribing variations using chi-squared and Fisher's exact tests.

Main Results:

• Obesity medications were prescribed to 20% (927/4628) of patients.
• Topiramate (37%) and metformin (43%) were most common ObMs.
• ObM recipients were older, had more severe obesity (Class 2/3), and more comorbidities, but similar demographics.

Conclusions:

• Obesity medication prescribing in youth is strongly associated with older age, greater obesity severity, and presence of comorbidities.
• Prescribing programs varied, with some initiating ObMs earlier and using multiple medications more frequently.
• Further research into earlier ObM initiation is warranted to prevent progressive obesity-related disease.