The relationship between BMI and the prescription of anti-obesity medication according to social factors: a population cross sectional study.
BACKGROUND
Obesity is a global public health problem. There are a range of treatments available with varying short and long term success rates. One option is the use of anti-obesity medication the prescription of which has increased dramatically in recent years. Despite this, little is known about the individual and GP practice factors that influence the prescription of anti-obesity medication.


METHODS
Multi-level logistic regression analysis was used to investigate factors associated with the prescription of anti-obesity medication in Northern Ireland using a population primary care prescribing database (~1.5 million people aged 16+ years) during 2009/10.


RESULTS
While 25.0% of people are obese, only 1.3% (2.1% of females, 0.6% of males) received anti-obesity medication. The relationship between medication rates and age differed by gender (P < 0.001) with prescriptions higher in younger females and older males. Prescribing of anti-obesity medication reflected obesity prevalence across urban/rural areas and deprivation. There was an unexplained two-fold difference, between the 25th and 75th percentile, in the GP practice prescription of anti-obesity medication.


CONCLUSIONS
There is evidence of relative under-prescribing in males compared to females despite a similar prevalence of obesity. While the prevalence (and presumably the health consequences) of obesity worsens with age, younger females are more likely to be prescribed anti-obesity medication. This suggests an element of patient demand. Educational material to improve the understanding of the role of anti-obesity medication, for patients and practitioners, is recommended. But further study is needed to understand the factors responsible for the variation in prescribing between GP practices.
UKCRC Centre of Excellence for Public Health (Northern Ireland), Queen's University Belfast, Belfast BT12 6BJ, Northern Ireland. l.patterson@qub.ac.uk.
Lynsey
L
Patterson
Frank
F
Kee
Carmel
C
Hughes
Dermot
D
O'Reilly
D000367:Age Factors; D019440:Anti-Obesity Agents / Q000627:therapeutic use*; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D058005:General Practitioners / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D009660:Northern Ireland / Q000453:epidemiology; D009765:Obesity / Q000188:drug therapy*; D010818:Practice Patterns, Physicians'; D012737:Sex Factors; D012959:Socioeconomic Factors
D019440:Anti-Obesity Agents