Retrospective descriptive analysis of a managed care population with obesity

Abstract

Objectives

To reveal the extent of obesity in a single healthcare system and provide a blueprint for other health systems to perform similar analyses, this study describes characteristics and weight change patterns of patients classified with overweight and obesity at a large integrated delivery network (IDN) in the South-Central United States.

Methods

A descriptive, observational, retrospective study was conducted using electronic medical records and claims data. Patients were ≥18 years old, body mass index (BMI) ≥27 kg/m², and continuously enrolled in the IDN plan for ≥6 months before and ≥12 months after the index date. Demographics, comorbidities, BMI, and weight were collected. Weight changes were assessed annually, and anti-obesity medications (AOM) use was also captured.

Results

A total of 36,430 eligible patients were identified. A subset of 22,712 patients was continuously enrolled for the entire study period (mean age: 57.2) and were primarily white (83.3%) and commercially insured (54.3%). Most patients were categorized as overweight (40.1%) or obesity class I (32.5%) at baseline. At years 1 and 4 post-index, patients who maintained index weight (±3%) was 56.2% and 37.0%, respectively, whereas weight gain (≥3% increase) was 23.7% and 33.3%, respectively. AOM use (1.1%) primarily consisted of phentermine-hydrochloride (n = 114, 0.5%) and orlistat (n = 115, 0.5%).

Conclusions

An increasing proportion of patients gained weight over time, combined with low AOM use, emphasizing the need for weight-loss interventions in this population. Findings from this study provide a foundation for health systems to perform similar analyses.

Keywords:

• Anti-obesity agents
• retrospective studies
• obesity
• delivery of health care, integrated
• electronic health records

Transparency

Declaration of funding

This study was supported by Novo Nordisk, Inc.

Declaration of financial/other relationships

A Ramasamy, and C Walker are employees of Novo Nordisk, Inc., which sponsored this research. At the time the study was conducted, N Kumar and M Mocarski were employees of Novo Nordisk, Inc. M Mocarski and A Ramasamy own stock in Novo Nordisk. A Osterland, C King, and P Godley are employees of Baylor Scott and White Health System, which received funding to conduct the research study on which the manuscript is based. At the time the study was conducted H Darji was an employee of Baylor Scott and White Health System. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

Conception and design: AO, CK, NK, MM, AR, and PG contributed to conception and design of the study. Analysis and interpretation: All authors contributed to analysis and interpretation. Manuscript preparation: All authors participated in manuscript preparation.

Acknowledgements

Writing assistance was provided by Elizabeth Tanner of KJT Group, Inc. and funded by Novo Nordisk, Inc.