The Use of Telemedicine for Obesity Pharmacotherapy in Patients With Overweight or Obesity

• Published in: Obesity (Silver Spring, Md.) Md.), 2022-11, Vol.30, p.45-45
• Main Authors: Griebeler, Marcio, Butsch, W Scott, Rodriguez, Paloma, Lomeli, Laura, Kampert, Matthew, Makin, Vinni, Abed, Ula, Borukh, Elena, Daigle, Erin, Bena, James, Pantalone, Kevin, Burguera, Barto
• Format: Article
• Language: English
• Subjects: Obesity; Telemedicine; Weight control
• ISSN: 1930-7381; 1930-739X

Marcio Griebeler MD, W Scott Butsch MD, MSc, FTOS, Paloma Rodriguez, Laura Lomeli BA/BS, Matthew Kampert, Vinni Makin, Ula Abed, Elena Borukh, Erin Daigle, James Bena MS, Kevin Pantalone DO ECNU FACE, Barto Burguera MD PhD Background: Obesity is a chronic disease and a major healthcare problem in the USA increasing the risk of other comorbidities . The cornerstone for treatment is behavioral and lifestyle changes; however, antiobesity medications are often required. Telemedicine has emerged as an effective way to deliver obesity care, allowing providers to reach patients and overcome barriers in access, exacerbated by the pandemic. This trial was conducted to show the effectiveness and safety of obesity treatment with phentermine via telemedicine. The goal was to demonstrate non-inferiority using telehealth in treating obesity with phentermine in patients with BMI > 27 kg/m2 with comorbidities or BMI > 30 kg/m2 compared to the standard in-person visits. Methods: 12-week, randomized, single-center trial. The primary endpoint was mean change in body weight (percentage) from baseline to 12 weeks using a non-inferiority approach assuming a 3% region. Eligible participants included adults age 18-65 years old who had a smartphone and the ability to use a virtual visit platform. Results: 70 patients were enrolled and were predominately (90%) women with a mean age of 42.2 y and baseline weight of 250.7 lbs. The mean BMI was 41.2 kg/m2. The weight loss in the virtual visit group was non-inferior to the in-person group at all time points, but was not superior. At 4 weeks, the mean change in weight was -4.2% among the virtual group and -3.43% among the in-person group, with a mean difference of 0.77 (95% CI: -2.4,0.86). At 12 weeks, the mean change in weight was -6.5% among the virtual group and -7.7% among the in-person group, with a mean difference of 1.16 (95% CI: -0.5, 2.82) with 65% of virtual patients, and 71% of in-person subjects demonstrating a weight reduction of at least 5%. There was no difference in tolerance, adherence and compliance. Conclusions: The use of telemedicine is safe and non-inferior when compared to in-person care achieving meaningful weight loss with the use of phentermine. Further clinical trials accessing not only short but long-term interventions for obesity care are necessary.