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

The national POWER registry of paediatric weight management programmes reported increased obesity medication (ObM) use in recent years. However, factors influencing ObM prescribing are not well understood. This study aimed to compare (1) clinical characteristics between youth prescribed ObMs and those who were not and (2) prescribing patterns among programmes.

Data from youth aged 6-18 years seen at 12 POWER sites between 2018 and 2024 were analysed. Clinical and demographic variables were compared between ObM and non-ObM groups using Fisher's exact test and logistic regression, adjusting for site. Site-level prescribing patterns were assessed using χ² and Fisher's exact tests.

ObMs were prescribed to 927 of 4628 (20%) patients. Topiramate (37%) and metformin (43%) were the most prescribed. ObM patients were older [12-15 years aOR (CI) = 1.7 (1.4, 2.0); 16-18 years aOR (CI) = 1.6 (1.3, 2.0) vs. 6-11 years], had more severe obesity [Class 2 aOR (CI) = 1.6 (1.3, 2.2); Class 3 aOR (CI) = 2.9 (2.3, 3.8) vs. Class 1] and had more obesity related co-morbidities, but demographic characteristics were not different. Higher prescribing programmes offered ObMs sooner and multiple ObMs more often.

ObM prescribing was strongly associated with age, obesity severity and comorbidities, highlighting the need for prospective studies on earlier initiation to prevent disease progression.