Weight Loss

Sonya Collins

In the last 20 years, the proportion of the U.S. adults who are obese has risen from just over 30% to nearly 42%. Obesity is increasingly being accepted as a chronic medical condition like any other—bolstered by FDA’s approval of GLP-1 receptor agonists to treat it, their widespread use, and positive outcomes for those with obesity.

According to a JAPhA paper published April 4, 2024, pharmacists are perfectly positioned to help manage this patient population as more patients seek treatment for obesity.

For the research, pharmacists at Tufts Medical Center saw 79 patients referred to a pharmacist-led weight loss service during a 6-month period. Pharmacists worked with the patients from initial medication selection through 6 months of follow-up. Patients enrolled in the program saw clinically significant weight loss.

“Pharmacists have so much experience with collaborative disease state management, like type 2 diabetes, anti-coagulation, and hypertension. Obesity falls into that same category, so this is just naturally a space that we are well positioned and prepared to fit into,” said Samantha Schermerhorn, PharmD, co-author of the paper and a clinical pharmacy specialist at Tufts Medical Center in Boston, MA.

Medication access and weight loss

Pharmacists at Tufts Medical Center led a weight-loss service at three ambulatory care clinics. Prior to the first appointment with patients, they selected an appropriate weight-loss medication based on the patient’s insurance coverage and comorbidities. When patients were eligible, pharmacists enrolled them in financial assistance programs or were able to offer them a discounted cash price for the medication.

“When you’re using a medication class where cost and accessibility are barriers, pharmacists are well equipped to address that,” Schermerhorn said.

Patients typically had the medication in hand at the first appointment, which facilitated injection training. Clinical services also included counseling on the dosing schedule, potential drug side effects, and lifestyle changes. When warranted, patients might receive a referral to a registered dietitian.

After an initial in-person or telehealth appointment, pharmacists followed up with patients via telehealth every 2 to 4 weeks, depending on the medication and patient needs, for 6 months. 

As weight-loss injectables require frequent follow-up with a clinician, Schermerhorn said, “Pharmacists are readily available to have a higher number of touch-points with the patients, even in between primary care visits.”

During the trial period, patients’ average weight at baseline was 232.6 lbs with a BMI of 38.1. After 6 months of follow-up, they’d lost an average 8% of their body weight. This outcome, Schermerhorn noted, was in line with outcomes achieved by the large randomized controlled STEP-1 trial, in which patients achieved 15% weight loss over a 68-week follow-up—more than twice as long as the follow-up in the Tufts’ program. 

A role for pharmacists everywhere

It’s outcomes like those seen in STEP-1 and at Tufts that have added to the surge in demand for GLP-1 receptor agonists and the subsequent far-reaching shortages.

Pharmacists are ready to handle that challenge, too, Schermerhorn said. “We have a good understanding of these medications, so we’re able to navigate national shortages and help patients switch between medications if we need to.”

While the Tufts’ program takes place in the ambulatory diabetes and primary care clinics of an academic medical center, the article highlights roles pharmacists can play in obesity management in all types of settings.

 “In disease states that are medication-heavy and where there are potential side effects and cost barriers, that’s our area of specialty,” Schermerhorn said. “That’s where pharmacists can shine.”  ■