More than 85% of doctors report an increased number of patients asking about weight-loss medication over the past 12 months, but many lack confidence to discuss newer treatments, according to an exclusive AusDoc survey.

The survey generated 391 responses, 65% of which were from GPs and GP registrars, followed by endocrinologists, cardiologists and other specialists.

More than 74% had given patients advice about obesity in the previous week. However, a minority were completely confident to answer patient questions about newer treatments (24%) or initiate a conversation about weight-loss (30%).

Of those respondents who don’t prescribe weight-loss medication, 33% gave lack of knowledge as the reason.

“This confidence gap is an opportunity for pharmaceutical companies to share the latest data and KOL advice,” says AusDoc MD Bryn McGeever. “Our audience-engagement data show that doctors are highly receptive to informative pharma company content published on our platform.”

“What are the reasons that you don’t currently prescribe weight-loss medications to your patients?”

  • 33% – Concerned about side effects or safety
  • 33% – Don’t know enough about it
  • 30% – Expensive for patients
  • 28% – Concerned about long-term efficacy
  • 21% – Concerned about rebound weight gain
  • 21% – Moves patient from one dependency to another
  • 21% – Lack of understanding about dosing and titration

When asked “What additional support do you believe would help you in prescribing weight-loss medications?” doctors cited:

  • 40% – Educational resources
  • 30% – Patient management tools
  • 20% – Financial incentives
  • 10% – Peer support

When it comes to their preferred method for learning about weight-loss interventions, the top 5 were:

  • 60% – Online education (CPD accredited)
  • 58% – Educational webinars
  • 43% – Independent (non-pharma) medical websites
  • 36% – Workshops / roundtables / small meetings
  • 28% – Virtual (online) congresses and symposia

On a positive note, one doctor said: “I have treated many people with obesity, including myself, and am confident in the medications and lifestyle treatments.”

However, another was concerned that initiating a conversation could upset patients: “There’s a lot of stigma attached to actually bringing up obesity. People are easily offended.”

A strong theme was the need for more information about treatments. “I am not so confident with some of the newer treatments,” said a doctor. Several doctors asked for access to studies and data about the safety and efficacy of medications on the market.

When asked which weight-loss treatments they had prescribed, 75% said injectables and 70% said oral medication. In addition:

  • 88% had referred to a dietician
  • 71% had referred to a bariatric surgeon
  • 69% had referred to an exercise physiologist or physiotherapist
  • 62% had recommended meal replacements or a low-energy diet; and
  • 45% had referred to a psychologist

Two-thirds of respondents agreed that weight-loss medications are appropriate for most patients with obesity or weight-related comorbidities. However, 15% disagreed and 18% were undecided.

Several respondents pointed to the complexities of treating obesity and explained that they treat each case on its merits. “One-size-fits-all seldom works with weight-loss,” said a doctor.

Another shared their approach: “Most people who come in asking about medication have already tried diet and exercise before seeing a doctor about it. So, medication would be an adjunct treatment. When I bring up obesity, patients may not have tried a lifestyle plan as yet, and I encourage them to do this first before prescribing medication.”

Overall, the strongest theme was that sustained weight-loss needs a multifaceted approach with a combination of medication, dietary education and exercise.

To conclude, here’s a selection of free-text thoughts shared by the respondents:

  • “It’s not one or the other. Non-pharm and pharm management need to co-exist.”
  • “Medications are helpful to kick-start the process for patients struggling to lose weight.”
  • “Many but not all patients who have tried and struggled to lose weight, who have obesity complications, would benefit from a trial of weight-loss injections.”
  • “Medication is only a temporary measure. Lifestyle – diet and exercise – is more important.”
  • “Given the amount of metabolic syndrome in my patient cohort, weight-loss medications, especially GLP1-RAs, can be very valuable. Unfortunately, the cost for sustained benefit is prohibitive for most of my patients.”

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References

Source: AusDoc survey. Understanding doctor insights and behaviours with the use of weight-loss medications (May 2024) n = 391