GLP‐1 RA Use and Weight Loss Among Patients in a Weight Navigation Program Versus Primary Care: A Matched Cohort Study

ABSTRACT Objective In general practice settings, the weight‐loss effectiveness of glucagon‐like peptide 1 receptor agonists (GLP‐1 RAs) is often lower than in clinical efficacy trials. Little is known about whether this may be due, in part, to clinicians' knowledge about obesity medicine and the nature of clinic visits (e.g., weight‐focused vs. general primary care). This study evaluates GLP‐1 RA prescription rates and weight loss among patients prescribed anti‐obesity medications (AOMs) and who either did or did not participate in a weight navigation program (WNP) consisting of weight‐focused visits with primary care physicians certified in obesity medicine through the American Board of Obesity Medicine. Methods In this retrospective cohort evaluation, primary care patients with obesity who were prescribed AOMs and had a WNP visit were matched 1:5 to those who were prescribed AOMs and did not have a WNP visit. Primary outcomes were the percentage of patients prescribed GLP‐1 RAs and mean weight loss at 12 months. Results Compared with matched controls, WNP patients were less likely to be prescribed GLP‐1 RAs [average marginal effects (AME) (95% CI): −21.6% (−32.9% to −10.3%); p < 0.001] and more likely to be prescribed first generation oral AOMs. At 12 months, WNP patients lost 2.6 ± 1.3 kg more than matched controls (95% CI, 0.1–5.1; p = 0.04). Among those prescribed GLP‐1 RAs, WNP patients lost 5.3 ± 1.6 kg more (95% CI, 2.0 to 8.5; p = 0.001). Conclusions and Relevance WNP patients lost more weight than matched controls despite fewer prescriptions for GLP‐1 RAs. The clinical‐ and cost‐effectiveness of novel obesity care models such as WNP warrant further evaluation.