Despite nearly half of patients in a large health system being eligible for anti-obesity medications, only 1.4% actually received prescriptions.
1.4%Percentage of eligible patients who were actually prescribed anti-obesity medications
What the researchers found
Only 1.4% of the 1.1 million patients eligible for anti-obesity medications were actually prescribed them.
Why it matters
Reveals a massive treatment gap between guideline-eligible patients and actual prescribing, suggesting significant barriers to accessing obesity pharmacotherapy.
The numbers in context
- 2,469,474 adults studied; 1,110,251 (45%) eligible for anti-obesity medication
- Only 15,214 (1.4%) of eligible patients received a prescription
- 69.4% of eligible patients had BMI of 30 or higher
- Musculoskeletal disorders affected 54% of eligible patients
- 62% of eligible patients had 2 or more obesity-related conditions
- Liraglutide 3.0 mg: 58% of prescriptions; semaglutide 2.4 mg: 34%
How the study worked
Cross-sectional analysis of electronic health records from a large multi-center U.S. health care system spanning 2018-2022.
Who was studied
N=2,469,474 adults in the Mass General Brigham health system, Boston, 2018-2022. Mean age 53, 57% female, mean BMI 28.1.
What this study cannot tell us
Single health system in the northeastern U.S. may not be nationally representative. Cannot determine why medications were not prescribed.
How to read the evidence
Large cross-sectional analysis of real-world health records. Strong for characterizing treatment patterns but cannot explain causation.
When this study was published
Published in 2025 using data from 2018-2022.
The bigger picture
This enormous prescribing gap highlights systemic barriers including stigma, cost, insurance coverage, and physician training that prevent effective obesity treatment.
Questions still open
- What are the primary barriers preventing physicians from prescribing anti-obesity medications?
- Has the prescribing gap narrowed since newer GLP-1 medications became available?
Common questions
Why are so few eligible patients getting weight-loss drugs?
Which weight-loss medications were prescribed most often?
Read the original research
Contemporary treatment patterns of overweight and obesity: insights from the Mass General Brigham health care system.
Obesity (Silver Spring, Md.), 33(2), 365-384
Citation
Ostrominski, John W; Wagholikar, Kavishwar B; Olsson, Kelly; Unlu, Ozan; Zelle, David; Kumar, Sanjay; Smith, Austen M; Toliver, Joshua C; Michalak, Wojciech; Fabricatore, Anthony; Hartaigh, Bríain Ó; Baer, Heather J; Cannon, Christopher P; Apovian, Caroline M; Fisher, Naomi D L; Plutzky, Jorge; Scirica, Benjamin M; Blood, Alexander J. (2025). Contemporary treatment patterns of overweight and obesity: insights from the Mass General Brigham health care system.. Obesity (Silver Spring, Md.), 33(2), 365-384. https://doi.org/10.1002/oby.24186