JMIR Publications

ABSTRACT

Background:

Despite the increasing prevalence of obesity, use of pharmacotherapy treatment remains low, and access-to-care barriers persist. Telehealth platforms have the potential to facilitate access to pharmacotherapy interventions, but little is known about populations receiving telehealth treatment.

Objective:

This study describes a large patient population treated with prescription Plenity®, an oral superabsorbent hydrogel (OSH) for the treatment of excess weight or obesity (BMI 25-40kg/m2). In addition, the analysis compares differences in weight loss (WL) practices and in-person access to obesity care among telehealth patients with pre-obesity (PwPO) and patients with obesity (PwO).

Methods:

This is a cross-sectional assessment of a random sample of 20,000 telehealth weight management patients who completed a structured, online visit and had received at least one prescription of OSH. Patients were eligible to receive care via telehealth and were included in the analysis if they were adults, not pregnant, and had a minimum BMI of 25kg/m2. In the visit, patients provided baseline health information including comorbidities and diet and exercise habits. Patients were also geolocated in their zip code of residence to determine whether they had access to an obesity medicine provider. Descriptive statistical analysis and tests of differences (χ2, t-tests) were used to compare PwPO (BMI 25-29.9 kg/m2, n=6,426) and PwO (BMI 30-40 kg/m2, n=13,574).

Results:

Patients were 78% female, aged 44 ± SD 11 years, with a mean BMI of 32.4 kg/m2 (SD 4.1). One-third of patients (32.1%) had pre-obesity and 40.2% of all patients had at least one weight-related comorbidity. Almost all patients (98.7%) attempted one WL method prior to OSH, and half (50.3%) tried at least four different methods. Exercise and low-calorie diet were the most attempted WL methods, and nearly 30% of patients reported prior prescription WL medication use. Most patients (62.2%) did not follow a specific diet at the time of OSH initiation. PwO were more likely than PwPO to have previously tried commercial WL plans (53.7 vs 43.4%; P<.001), specialized diets (62.6 vs 59.1%; P<.001), OTC supplements (50.2 vs 44.8%; P<.001) and prescription WL medications (32.5 vs 20.9%; P<.001). Females were more likely to seek treatment for pre-obesity (34.2 vs. 24.7% male; P<.001) and reported fewer comorbidities (38.5 vs. 46.2% male; P<.001), despite over 90% of both sex groups reporting the belief that excess weight negatively affected their health. 29.3% of people lived in the same zip code and 85.2% in the same county as an obesity medicine provider.

Conclusions:

Data from this large patient cohort supports the potential for telehealth to provide prescriptive weight management treatment to a population seeking care. PwPO are an undertreated population and are actively seeking new weight management options. Women sought weight management treatment earlier in the disease continuum than men, despite reporting fewer comorbidities.