People of Color Less Likely to Use Obesity-Management Medications

By BDOPro Editors
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(HealthDay News) — Racial and ethnic disparities are seen in the use of obesity-management medications, according to a study published online Dec. 17 in the Journal of Racial and Ethnic Health Disparities.

Kimberly Narain, M.D., M.P.H., Ph.D., from the University of California, Los Angeles, and Christopher Scannell, M.D., Ph.D., from the University of Southern California in Los Angeles, assessed racial and ethnic differences in the utilization of obesity-management medications among clinically eligible individuals. The analysis included data from the Medical Expenditure Panel Survey (2011 to 2016, 2018, and 2020) for adult participants with a body mass index ≥30 kg/m² and individuals with a body mass index ≥27 kg/m² with one or more weight-related conditions.

The researchers found that Asian (adjusted odds ratio, 0.36), Black (adjusted odds ratio, 0.51), and Hispanic individuals (adjusted odds ratio, 0.70) had significantly lower odds of utilizing obesity-management medications compared with White individuals. Among Black and Hispanic individuals, factors partially accounting for these disparities included lower levels of education, lack of health insurance, and higher levels of public health insurance.

“These findings call for the continued exploration of the utilization and perception toward the ever-evolving and modernizing obesity medication market,” the authors write. “Understanding the perceptions of all populations toward emerging and popularized treatment options is essential to minority health.”

Barriers to weight loss drug access

Access to weight loss medications, while offering a promising tool in the fight against obesity, is hampered by several significant barriers. These barriers span financial, systemic, and informational realms, preventing many individuals who could benefit from these treatments from accessing them.

Cost

One of the most significant obstacles is the high cost of many newer weight loss medications. These drugs are often not covered by insurance plans, or coverage may be limited with stringent pre-authorization requirements. This leaves patients facing substantial out-of-pocket expenses, making them unaffordable for many, particularly those from lower socioeconomic backgrounds who are often disproportionately affected by obesity. Even when insurance does offer coverage, high co-pays or deductibles can still present a financial burden. This cost barrier creates a significant disparity in access, favoring those with greater financial resources.

Insurance coverage

Beyond cost, insurance coverage itself presents a major hurdle. Many insurance companies classify weight loss medications as “lifestyle” drugs, deeming them non-essential and thus excluding them from formularies. This classification ignores the complex medical nature of obesity and the potential health benefits of weight loss medications in preventing or managing related conditions like type 2 diabetes, heart disease, and sleep apnea. Even when coverage is available, it often comes with strict criteria, such as a high BMI threshold, documented attempts at diet and exercise, and sometimes even mandatory participation in weight management programs. These requirements can be difficult to meet and create additional administrative burdens for both patients and healthcare providers.

Lack of knowledgeable healthcare providers

Another significant barrier is the limited number of healthcare providers who are knowledgeable and comfortable prescribing weight loss medications. Many primary care physicians lack specialized training in obesity management and may be hesitant to prescribe these medications due to concerns about potential side effects or a lack of familiarity with prescribing guidelines. This lack of provider expertise can lead to missed opportunities for patients who could benefit from pharmacotherapy. Furthermore, access to specialists like endocrinologists or bariatric physicians, who are more likely to prescribe these medications, can be limited, especially in rural areas or for individuals with limited insurance options.

Misinformation and stigma

Finally, misinformation and stigma surrounding obesity and its treatment also create barriers. Negative perceptions about obesity as a personal failing rather than a complex medical condition can deter individuals from seeking medical help, including medication. Misinformation about the safety and efficacy of weight loss medications, often fueled by sensationalized media reports or unfounded online claims, can also create fear and reluctance among patients. This underscores the need for accurate and accessible information about weight loss medications and for efforts to combat the stigma associated with obesity. Overcoming these barriers requires a multi-pronged approach involving policy changes to improve insurance coverage, increased education for healthcare providers, and public health campaigns to address misinformation and stigma.