JAMA Sub-Journal: Lose weight while working?

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Obesity is an increasingly serious public health threat, placing a heavy burden on health and the economy
.

It is estimated that the prevalence of obesity among American adults from 2017 to 2018 was 42.

Obesity is the biggest contributor to obesity

Age-adjusted trends in overweight, obesity, and severe obesity: United States, 1960-1962 to 2017-2018

Life>the basis for the prevention and treatment of obesity, but the effectiveness of this traditional method is usually limited, and most obese patients are difficult to achieve and maintain clinically meaningful Weight loss
.

The US Food and Drug Administration Bureau ( the FDA ) approved drug for chronic weight management, anti-obesity drugs (AOM) may be a useful adjunct to life>

Preventive Management FDA

Practical research design can bridge the gap between clinical trials and clinical practice, provide valuable evidence of real-world effectiveness, and have rigorous randomized clinical trials (RCT) to provide information for clinicians, employers, and patients to make treatment decisions
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A recent study showed that when obese adults received chronic weight management drugs in a weight management plan provided by their employers, their weight was significantly reduced compared to adults who did not receive medication
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The study, published in JAMA Network Open on

Compared with adults who did not receive medication, when obese adults received chronic weight management medications in the weight management plan provided by their employers, their weight was significantly reduced

Effectiveness of Combining Antiobesity Medication With an Employer-Based Weight Management Program for Treatment of Obesity: A Randomized Clinical Trial.

The findings support the need for a multidisciplinary weight management plan to treat patients, which incorporates safe and effective medications to lose weight and maintain weight
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Doctors prescribe drugs to treat some of the health consequences associated with obesity, such as high blood pressure and type 2 diabetes

diabetes

The Centers for Disease Control and Prevention (CDC) reports that more than 42% of American adults suffer from obesity
.

In addition to obesity-related serious health conditions-such as type 2 diabetes, obstructive sleep apnea, high blood pressure, heart disease, and stroke, the CDC also reported on the economic impact of obesity on the U.

This one-year, single-center, practical clinical trial was conducted in a realistic environment of a workplace health plan
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The study included 200 adults with obesity (BMI ≥ 30) who participated in the Cleveland Clinic Employee Health Program from January 2019 to May 2020

In this real-world environment, eligible participants are randomly assigned 1:1 to a weight management plan with FDA-approved anti-obesity drugs or a separate weight management plan
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The weight management program is managed through monthly common medical appointments (SMAs), providing a multidisciplinary approach, including nutrition education
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The monthly SMA visits focus on adopting a healthier life>
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Due to the COVID-19 pandemic, some SMAs are conducted in a virtual way
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100 study participants were randomly assigned to a weight management plan and received medications.
According to the recommended clinical practice, they received a prescription at the monthly SMA
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Prescribe one of five FDA-approved chronic weight management drugs for patients: Orlistat, Locasserin, Phentermine/Topiramate, Naltrexone/Ibuprofen, Liraglutide 3.
0mg
.
The choice of medication for each patient is determined by the therapist and determined after a thorough evaluation and discussion with the participants
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(Locacerin has been withdrawn from the market in February 2020.

At that time, 8 patients who took locaselin were notified immediately and changed or stopped taking their medicines due to the end of the study
.
)

The results of the study showed that participants who took anti-obesity drugs had a greater average weight loss (-7.
7%) at 12 months compared to participants who only participated in the weight management program (-4.
2%)
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In the drug-available group , 62.
5% of participants lost at least 5% of their body weight, compared with 44.
8% in the group that only used a weight management plan
.
Among participants who received weight-loss drugs, SMA appeared more frequently .

Compared with the participants who only participated in the weight management program (-4.
2%), the participants who took anti-obesity drugs had a greater average weight loss at 12 months (-7.
7%)
.
In the drug-available group, the participants who took the anti-obesity drug had a greater average weight loss (-7.
7%) at 12 months compared with the participants who only participated in the weight management program (-4.
2%)
.
In the group of drugs can be used in , , 62.
5% of the participants at least reduce the 5% of body weight, while the group using only weight management program, compared with 44.
8% in
.
Among the participants who received weight-loss drugs, 62.
5% of
SMA participants lost at least 5% of their weight, compared with 44.
8% in the group that only used a weight management plan .
Participants in the weight-loss drugs get in, SMA appear appear higher rate
.
The rate is higher
.

Percent change in weight from baseline to 12 months

Percent change in weight from baseline to 12 months

The effect of treatment on changes in secondary endpoints of work productivity and work restrictions

The effect of treatment on changes in secondary endpoints of work productivity and work restrictions

Researchers say that many patients have improved their health after losing 5% of their weight
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According to the results of the study, the use of anti-obesity drugs combined with a multidisciplinary weight management program provides more effective treatment than weight management programs that do not use these drugs
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Obesity is associated with decreased workplace productivity, including absenteeism and attendance, but studies evaluating changes in work productivity after weight loss are limited, especially in terms of the impact of AOM
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In this study, the changes in work efficiency and restriction assessment were small, and the differences between treatment groups were meaningless
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Although the study did not have the ability to assess these endpoints, the ceiling effect may affect the results
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The low baseline injury level reported may be related to the sedentary workplace in the study environment
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The burden of obesity varies by employer industry; therefore, the impact of weight loss on productivity measures is affected by the industry environment
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In addition, although the magnitude of weight loss is clinically significant, it may not be large enough or the follow-up time is not long enough to affect these measures
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Finally, switching to virtual SMA resulted in loss of PRO data
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The limited availability and coverage of anti-obesity drugs prevents proper use
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A better understanding of the cost-benefit balance of AOM in an employer-based environment, including their impact on the indirect and direct costs of obesity, and drug purchase costs, is necessary to provide information for insurance decisions
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The impact of AOM on indirect costs through increased productivity is still an important research area, targeting people with different workplace settings or with higher baseline impairments
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14 The weight loss of obese patients is related to a significant reduction in direct medical care costs
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This study addresses an important evidence gap in the true effectiveness of AOMs in an employer-based environment
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This practical RCT reflects real-world medical practice in the workforce, and the results show that AOMs used in conjunction with an interdisciplinary obesity management health plan can produce clinical benefits similar to those seen in RCTs
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Such results should provide employers with decisions about employees’ access to these drugs and guide the development of best practice for employer-based comprehensive interdisciplinary weight management programs
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Of course, there is still need to further study the economic effects of obtaining AOMs in an employer-based environment in the real world, considering the performance and function of employees, drug costs, and reducing other obesity-related medical expenses
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Long-term and pragmatic RCTs conducted in multiple different industry environments may solve these problems and further clarify the cost-benefit balance of AOMs
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