Who is Responsible for Prescribing Weight Loss Medications to Obese Patients with Thomas Wadden, PhD


After providing insight into the results of the STEP 1 and STEP 3 trials, Dr. Wadden discusses who he believes the responsibility for prescribing these medications will fall unto if semaglutide receives approval as a weight loss agent.

As the push for more robust and a greater variety of obesity treatments reaches a fever pitch, the conversation has begun to evolve and include the question about who should be in charge of prescribing new medications for weight loss.

While the answer for years has been clinicians specializing in bariatric surgery, the explosion in obesity prevalence has meant that responsibility now extends to other specialties, including endocrinology, internal medicine, and sometimes cardiologists. With subcutaneous semaglutide showing promise in the STEP program and up for FDA approval as early as June, this question is being pushed to the forefront.

STEP 1, which randomized obese patients to semaglutide plus lifestyle intervention or place, indicated the 2.4 mg dose of semaglutide was associated with a 14.9% reduction in body weight and 86.4% of patients receiving the GLP1-RA achieved weight loss of 5% or more. In STEP 3, which included a more intense lifestyle intervention, results demonstrated a 16% reduction in body weight with semaglutide and suggested more than 75% of participants receiving semaglutide saw reductions in body weight of 10% or greater.

For more perspective on who should be responsible for engaging with these patients and initiating therapy with an agent like subcutaneous semaglutide, Endocrinology Network reached out to Thomas Wadden, PhD, professor of Psychology at the Perelman School of Medicine and principal investigator in the STEP program.

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