Why Are So Few Eligible Patients Actually Getting Prescribed Weight-Loss Medications?

Despite nearly half of patients in a large health system being eligible for anti-obesity medications, only 1.4% actually received prescriptions.

Ostrominski, John W et al.·Obesity (Silver Spring·2025·Moderate EvidenceCross-Sectional
RPEP-12886Cross SectionalModerate Evidence2025RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Moderate Evidence
Sample
N=2,469,474
Participants
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 Found

Only 1.4% of the 1.1 million patients eligible for anti-obesity medications were actually prescribed them.

Key Numbers

  • 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 They Did This

Cross-sectional analysis of electronic health records from a large multi-center U.S. health care system spanning 2018-2022.

Why This Research Matters

Reveals a massive treatment gap between guideline-eligible patients and actual prescribing, suggesting significant barriers to accessing obesity pharmacotherapy.

The Bigger Picture

This enormous prescribing gap highlights systemic barriers including stigma, cost, insurance coverage, and physician training that prevent effective obesity treatment.

What This Study Doesn't Tell Us

Single health system in the northeastern U.S. may not be nationally representative. Cannot determine why medications were not prescribed.

Questions This Raises

  • ?What are the primary barriers preventing physicians from prescribing anti-obesity medications?
  • ?Has the prescribing gap narrowed since newer GLP-1 medications became available?

Trust & Context

Key Stat:
1.4% Percentage of eligible patients who were actually prescribed anti-obesity medications
Evidence Grade:
Large cross-sectional analysis of real-world health records. Strong for characterizing treatment patterns but cannot explain causation.
Study Age:
Published in 2025 using data from 2018-2022.
Original Title:
Contemporary treatment patterns of overweight and obesity: insights from the Mass General Brigham health care system.
Published In:
Obesity (Silver Spring, Md.), 33(2), 365-384 (2025)
Database ID:
RPEP-12886

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

A snapshot of a population at one point in time.

What do these levels mean? →

Frequently Asked Questions

Why are so few eligible patients getting weight-loss drugs?

The study did not determine specific reasons, but likely barriers include cost, insurance coverage limitations, provider awareness, and obesity stigma.

Which weight-loss medications were prescribed most often?

Liraglutide 3.0 mg accounted for 58% of prescriptions and semaglutide 2.4 mg for 34%.

Read More on RethinkPeptides

Cite This Study

RPEP-12886·https://rethinkpeptides.com/research/RPEP-12886

APA

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

MLA

Ostrominski, John W, et al. "Contemporary treatment patterns of overweight and obesity: insights from the Mass General Brigham health care system.." Obesity (Silver Spring, 2025. https://doi.org/10.1002/oby.24186

RethinkPeptides

RethinkPeptides Research Database. "Contemporary treatment patterns of overweight and obesity: i..." RPEP-12886. Retrieved from https://rethinkpeptides.com/research/ostrominski-2025-contemporary-treatment-patterns-of

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkPeptides research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.