A Review of Racial and Ethnic Disparities in Obesity Treatment
Main Article Content
Abstract
This paper examines disparities in obesity treatment and their implications for health equity. A comprehensive literature review was performed using Pubmed, Medline, and Google Scholar to identify studies examining obesity treatment options that reported data on African Americans, Asians, Hispanics, and Caucasians. These studies, published from 2000 to 2022, revealed disparities in behavioral/lifestyle, surgical, and pharmacological interventions for obesity. While a majority of behavioral/lifestyle and surgical treatment studies found disparities in weight loss and clinical outcomes, pharmacological studies found minimal to no evidence of disparities or favorable outcomes for racial and ethnic minorities for weight and cardiometabolic outcomes. All treatment pathways showed disparities in referral rates, access, and engagement/retention. These findings underscore the urgent need to incorporate obesity treatment as a central component in strategies addressing health inequities. By understanding and addressing these disparities, healthcare equity can be improved, ensuring a more inclusive approach to obesity management.
Keywords:
obesity, racial disparities, obesity treatment, weight loss, bariatric surgery, obesity medications
Article Details
How to Cite
LELE, Raj et al.
A Review of Racial and Ethnic Disparities in Obesity Treatment.
Medical Research Archives, [S.l.], v. 11, n. 12, dec. 2023.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/4757>. Date accessed: 20 may 2024.
doi: https://doi.org/10.18103/mra.v11i12.4757.
Section
Review Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
1. Obesity, Race/Ethnicity, and COVID-19 | Overweight & Obesity | CDC [Internet]. [cited 2022 Jul 20];Available from: https://www.cdc.gov/obesity/data/obesity-and-covid-19.html
2. Malik P, Patel U, Patel K, et al. Obesity a predictor of outcomes of COVID-19 hospitalized patients-A systematic review and meta-analysis. J Med Virol 2021;93(2):1188–93.
3. Johnson KA, Jones-Smith J, Curriero FC, et al. Low-Income Black and Hispanic Children’s Neighborhood Food Environments and Weight Trajectories in Early Childhood. Acad Pediatr 2020;20(6):784–92.
4. Hales CM, Carroll MD, Fryar CD, Ogden CL. Prevalence of Obesity Among Adults and Youth: United States, 2015-2016. NCHS Data Brief 2017;(288):1–8.
5. Byrd AS, Toth AT, Stanford FC. Racial disparities in obesity treatment. Curr Obes Rep 2018;7(2):130–8.
6. O’Neal LJ, Perri MG, Befort C, et al. Differential impact of telehealth extended-care programs for weight-loss maintenance in African American versus white adults. J Behav Med 2022;45(4):580–8.
7. Annesi JJ. Relations of changes in exercise self-efficacy, physical self-concept, and body satisfaction with weight changes in obese white and African American women initiating a physical activity program. Ethn Dis 2007;17(1):19–22.
8. Hollis JF, Gullion CM, Stevens VJ, et al. Weight loss during the intensive intervention phase of the weight-loss maintenance trial. Am J Prev Med 2008;35(2):118–26.
9. Cromer SJ, Meigs J, Wexler DJ. Racial/ethnic and socioeconomic disparities in weight outcomes, cardiovascular events, and mortality in the look AHEAD trial. Diabetes Res Clin Pract 2022;192:110095.
10. Katzmarzyk PT, Martin CK, Newton RL, et al. Weight Loss in Underserved Patients - A Cluster-Randomized Trial. N Engl J Med 2020;383(10):909–18.
11. Daubenmier J, Chao MT, Hartogensis W, et al. Exploratory Analysis of Racial/Ethnic and Educational Differences in a Randomized Controlled Trial of a Mindfulness-Based Weight Loss Intervention. Psychosom Med 2021;83(6):503–14.
12. Butryn ML, Forman EM, Lowe MR, Gorin AA, Zhang F, Schaumberg K. Efficacy of environmental and acceptance-based enhancements to behavioral weight loss treatment: The ENACT trial. Obesity (Silver Spring) 2017;25(5):866–72.
13. Svetkey LP, Erlinger TP, Vollmer WM, et al. Effect of lifestyle modifications on blood pressure by race, sex, hypertension status, and age. J Hum Hypertens 2005;19(1):21–31.
14. West DS, Elaine Prewitt T, Bursac Z, Felix HC. Weight loss of black, white, and Hispanic men and women in the Diabetes Prevention Program. Obesity (Silver Spring) 2008;16(6):1413–20.
15. Brandon LJ, Elliott-Lloyd MB. Walking, body composition, and blood pressure dose-response in African American and white women. Ethn Dis 2006;16(3):675–81.
16. Glass JN, Miller WC, Szymanski LM. Physiological responses to weight-loss intervention in inactive obese African-American and Caucasian women. Journal of sports, 2002;
17. Nicklas BJ, Dennis KE, Berman DM, Sorkin J, Ryan AS, Goldberg AP. Lifestyle intervention of hypocaloric dieting and walking reduces abdominal obesity and improves coronary heart disease risk factors in obese, postmenopausal, African-American and Caucasian women. J Gerontol A Biol Sci Med Sci 2003;58(2):181–9.
18. Blackman Carr LT, Samuel-Hodge C, Ward DS, Evenson KR, Bangdiwala SI, Tate DF. Racial differences in weight loss mediated by engagement and behavior change. Ethn Dis 2018;28(1):43–8.
19. Coffino JA, Ivezaj V, Barnes RD, White MA, Pittman BP, Grilo CM. Ethnic and racial comparisons of weight-loss treatment utilization history and outcomes in patients with obesity and binge-eating disorder. Eat Behav 2022;44:101594.
20. Ostendorf DM, Blankenship JM, Grau L, et al. Predictors of long-term weight loss trajectories during a behavioral weight loss intervention: An exploratory analysis. Obes Sci Pract 2021;7(5):569–82.
21. Kinsey AW, Gowey MA, Tan F, et al. Similar weight loss and maintenance in African American and White women in the Improving Weight Loss (ImWeL) trial. Ethn Health 2018;1–13.
22. Cavallo DN, Martinez R, Webb Hooper M, Flocke S. Feasibility of a social media-based weight loss intervention designed for low-SES adults. Transl Behav Med 2021;11(4):981–92.
23. Saju R, Castellon-Lopez Y, Turk N, et al. Differences in weight loss by race and ethnicity in the PRIDE trial: a qualitative analysis of participant perspectives. J Gen Intern Med 2022;37(14):3715–22.
24. Haughton CF, Silfee VJ, Wang ML, et al. Racial/ethnic representation in lifestyle weight loss intervention studies in the United States: A systematic review. Prev Med Rep 2018;9:131–7.
25. Hecht LM, Pester B, Braciszewski JM, et al. Socioeconomic and racial disparities in bariatric surgery. Obes Surg 2020;30(6):2445–9.
26. Wee CC, Huskey KW, Bolcic-Jankovic D, Colten ME, Davis RB, Hamel M. Sex, race, and consideration of bariatric surgery among primary care patients with moderate to severe obesity. J Gen Intern Med 2014;29(1):68–75.
27. Stanford FC, Jones DB, Schneider BE, et al. Patient race and the likelihood of undergoing bariatric surgery among patients seeking surgery. Surg Endosc 2015;29(9):2794–9.
28. Ibrahim KD, Tragesser LA, Soans R, et al. Impact of racial disparities in preoperative cardiovascular evaluation and surgical outcomes in patients undergoing metabolic and bariatric surgery: A retrospective cohort analysis. J Am Heart Assoc 2022;11(11):e024499.
29. Hui BY, Roberts A, Thompson KJ, et al. Outcomes of bariatric surgery in african americans: an analysis of the metabolic and bariatric surgery accreditation and quality improvement program (MBSAQIP) data registry. Obes Surg 2020;30(11):4275–85.
30. Acevedo E, Lu X, Zhao H, Mazzei M, Sarvepalli S, Edwards MA. Outcomes in racial minorities after robotic Roux-en-Y gastric bypass and sleeve gastrectomy: a retrospective review of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database. Surg Obes Relat Dis 2021;17(3):595–605.
31. Samaan JS, Abboud Y, Yuan L, et al. Racial disparities in bariatric surgery postoperative weight loss and patient satisfaction. Am J Surg 2022;223(5):969–74.
32. Anderson WA, Greene GW, Forse RA, Apovian CM, Istfan NW. Weight loss and health outcomes in African Americans and whites after gastric bypass surgery. Obesity (Silver Spring) 2007;15(6):1455–63.
33. Cheung LK, Lal LS, Chow DS-L, Sherman V. Racial disparity in short-term outcomes after gastric bypass surgery. Obes Surg 2013;23(12):2096–103.
34. Elli EF, Gonzalez-Heredia R, Patel N, et al. Bariatric surgery outcomes in ethnic minorities. Surgery 2016;160(3):805–12.
35. Wee CC, Jones DB, Apovian C, et al. Weight loss after bariatric surgery: do clinical and behavioral factors explain racial differences? Obes Surg 2017;27(11):2873–84.
36. Edwards MA, Muraleedharan D, Spaulding A. Racial disparities in reasons for mortality following bariatric surgery. J Racial Ethn Health Disparities 2023;10(2):526–35.
37. Coleman KJ, Huang Y-C, Hendee F, Watson HL, Casillas RA, Brookey J. Three-year weight outcomes from a bariatric surgery registry in a large integrated healthcare system. Surg Obes Relat Dis 2014;10(3):396–403.
38. Coleman KJ, Brookey J. Gender and racial/ethnic background predict weight loss after Roux-en-Y gastric bypass independent of health and lifestyle behaviors. Obes Surg 2014;24(10):1729–36.
39. Smith ED, Layden BT, Hassan C, Sanchez-Johnsen L. Surgical treatment of obesity in latinos and african americans: future directions and recommendations to reduce disparities in bariatric surgery. Bariatric Surg Pract Patient Care 2018;13(1):2–11.
40. Fidler MC, Sanchez M, Raether B, et al. A one-year randomized trial of lorcaserin for weight loss in obese and overweight adults: the BLOSSOM trial. J Clin Endocrinol Metab 2011;96(10):3067–77.
41. McDuffie JR, Calis KA, Uwaifo GI, et al. Efficacy of orlistat as an adjunct to behavioral treatment in overweight African American and Caucasian adolescents with obesity-related comorbid conditions. J Pediatr Endocrinol Metab 2004;17(3):307–19.
42. Benneyworth BD, Brown K, Malik RE, Wang H, Frias JP. OR28-4 Efficacy and Safety of Tirzepatide Versus Semaglutide in a Hispanic or Latino Population: A Prespecified Subgroup Analysis of SURPASS-2. Journal of the Endocrine Society 2022;6(Supplement_1):A355–6.
43. DeSouza C, Cariou B, Garg S, Lausvig N, Navarria A, Fonseca V. Efficacy and safety of semaglutide for type 2 diabetes by race and ethnicity: A post hoc analysis of the SUSTAIN trials. J Clin Endocrinol Metab 2020;105(2).
44. O’Neil PM, Garvey WT, Gonzalez-Campoy JM, et al. Effects of liraglutide 3.0 mg on weight and risk factors in hispanic versus non-hipanic populations: subgroup analysis from scale randomized trials. Endocr Pract 2016;22(11):1277–87.
45. Davidson JA, Ørsted DD, Campos C. Efficacy and safety of liraglutide, a once-daily human glucagon-like peptide-1 analogue, in Latino/Hispanic patients with type 2 diabetes: post hoc analysis of data from four phase III trials. Diabetes Obes Metab 2016;
46. Shomali ME, Ørsted DD, Cannon AJ. Efficacy and safety of liraglutide, a once-daily human glucagon-like peptide-1 receptor agonist, in African-American people with Type 2 diabetes: a meta-analysis of sub-population data from seven phase III trials. Diabet Med 2017;34(2):197–203.
47. Aroda VR, Bauer R, Christiansen E, et al. Efficacy and safety of oral semaglutide by subgroups of patient characteristics in the PIONEER phase 3 programme. Diabetes Obes Metab 2022;24(7):1338–50.
48. Williams LK, Padhukasahasram B, Ahmedani BK, et al. Differing effects of metformin on glycemic control by race-ethnicity. J Clin Endocrinol Metab 2014;99(9):3160–8.
49. Heisler M, Faul JD, Hayward RA, Langa KM, Blaum C, Weir D. Mechanisms for racial and ethnic disparities in glycemic control in middle-aged and older Americans in the health and retirement study. Arch Intern Med 2007;167(17):1853–60.
50. Desouza C, Bain SC, Gondolf T, et al. P6271The effect of semaglutide once weekly on MACE and blood pressure by race and ethnicity: SUSTAIN 6 post hoc analysis. Eur Heart J 2019;40(Supplement_1).
51. Lu Y, Liu Y, Krumholz HM. Racial and ethnic disparities in financial barriers among overweight and obese adults eligible for semaglutide in the united states. J Am Heart Assoc 2022;11(19):e025545.
52. Elhussein A, Anderson A, Bancks MP, et al. Racial/ethnic and socioeconomic disparities in the use of newer diabetes medications in the Look AHEAD study. Lancet Reg Health Am 2022;6.
53. Wright DR, Guo J, Hernandez I. A prescription for achieving equitable access to anti obesity medications. JAMA Health Forum 2023;4(4):e230493.
54. Batsis JA, Huyck KL, Bartels SJ. Challenges with the Medicare obesity benefit: practical concerns & proposed solutions. J Gen Intern Med 2015;30(1):118–22.
2. Malik P, Patel U, Patel K, et al. Obesity a predictor of outcomes of COVID-19 hospitalized patients-A systematic review and meta-analysis. J Med Virol 2021;93(2):1188–93.
3. Johnson KA, Jones-Smith J, Curriero FC, et al. Low-Income Black and Hispanic Children’s Neighborhood Food Environments and Weight Trajectories in Early Childhood. Acad Pediatr 2020;20(6):784–92.
4. Hales CM, Carroll MD, Fryar CD, Ogden CL. Prevalence of Obesity Among Adults and Youth: United States, 2015-2016. NCHS Data Brief 2017;(288):1–8.
5. Byrd AS, Toth AT, Stanford FC. Racial disparities in obesity treatment. Curr Obes Rep 2018;7(2):130–8.
6. O’Neal LJ, Perri MG, Befort C, et al. Differential impact of telehealth extended-care programs for weight-loss maintenance in African American versus white adults. J Behav Med 2022;45(4):580–8.
7. Annesi JJ. Relations of changes in exercise self-efficacy, physical self-concept, and body satisfaction with weight changes in obese white and African American women initiating a physical activity program. Ethn Dis 2007;17(1):19–22.
8. Hollis JF, Gullion CM, Stevens VJ, et al. Weight loss during the intensive intervention phase of the weight-loss maintenance trial. Am J Prev Med 2008;35(2):118–26.
9. Cromer SJ, Meigs J, Wexler DJ. Racial/ethnic and socioeconomic disparities in weight outcomes, cardiovascular events, and mortality in the look AHEAD trial. Diabetes Res Clin Pract 2022;192:110095.
10. Katzmarzyk PT, Martin CK, Newton RL, et al. Weight Loss in Underserved Patients - A Cluster-Randomized Trial. N Engl J Med 2020;383(10):909–18.
11. Daubenmier J, Chao MT, Hartogensis W, et al. Exploratory Analysis of Racial/Ethnic and Educational Differences in a Randomized Controlled Trial of a Mindfulness-Based Weight Loss Intervention. Psychosom Med 2021;83(6):503–14.
12. Butryn ML, Forman EM, Lowe MR, Gorin AA, Zhang F, Schaumberg K. Efficacy of environmental and acceptance-based enhancements to behavioral weight loss treatment: The ENACT trial. Obesity (Silver Spring) 2017;25(5):866–72.
13. Svetkey LP, Erlinger TP, Vollmer WM, et al. Effect of lifestyle modifications on blood pressure by race, sex, hypertension status, and age. J Hum Hypertens 2005;19(1):21–31.
14. West DS, Elaine Prewitt T, Bursac Z, Felix HC. Weight loss of black, white, and Hispanic men and women in the Diabetes Prevention Program. Obesity (Silver Spring) 2008;16(6):1413–20.
15. Brandon LJ, Elliott-Lloyd MB. Walking, body composition, and blood pressure dose-response in African American and white women. Ethn Dis 2006;16(3):675–81.
16. Glass JN, Miller WC, Szymanski LM. Physiological responses to weight-loss intervention in inactive obese African-American and Caucasian women. Journal of sports, 2002;
17. Nicklas BJ, Dennis KE, Berman DM, Sorkin J, Ryan AS, Goldberg AP. Lifestyle intervention of hypocaloric dieting and walking reduces abdominal obesity and improves coronary heart disease risk factors in obese, postmenopausal, African-American and Caucasian women. J Gerontol A Biol Sci Med Sci 2003;58(2):181–9.
18. Blackman Carr LT, Samuel-Hodge C, Ward DS, Evenson KR, Bangdiwala SI, Tate DF. Racial differences in weight loss mediated by engagement and behavior change. Ethn Dis 2018;28(1):43–8.
19. Coffino JA, Ivezaj V, Barnes RD, White MA, Pittman BP, Grilo CM. Ethnic and racial comparisons of weight-loss treatment utilization history and outcomes in patients with obesity and binge-eating disorder. Eat Behav 2022;44:101594.
20. Ostendorf DM, Blankenship JM, Grau L, et al. Predictors of long-term weight loss trajectories during a behavioral weight loss intervention: An exploratory analysis. Obes Sci Pract 2021;7(5):569–82.
21. Kinsey AW, Gowey MA, Tan F, et al. Similar weight loss and maintenance in African American and White women in the Improving Weight Loss (ImWeL) trial. Ethn Health 2018;1–13.
22. Cavallo DN, Martinez R, Webb Hooper M, Flocke S. Feasibility of a social media-based weight loss intervention designed for low-SES adults. Transl Behav Med 2021;11(4):981–92.
23. Saju R, Castellon-Lopez Y, Turk N, et al. Differences in weight loss by race and ethnicity in the PRIDE trial: a qualitative analysis of participant perspectives. J Gen Intern Med 2022;37(14):3715–22.
24. Haughton CF, Silfee VJ, Wang ML, et al. Racial/ethnic representation in lifestyle weight loss intervention studies in the United States: A systematic review. Prev Med Rep 2018;9:131–7.
25. Hecht LM, Pester B, Braciszewski JM, et al. Socioeconomic and racial disparities in bariatric surgery. Obes Surg 2020;30(6):2445–9.
26. Wee CC, Huskey KW, Bolcic-Jankovic D, Colten ME, Davis RB, Hamel M. Sex, race, and consideration of bariatric surgery among primary care patients with moderate to severe obesity. J Gen Intern Med 2014;29(1):68–75.
27. Stanford FC, Jones DB, Schneider BE, et al. Patient race and the likelihood of undergoing bariatric surgery among patients seeking surgery. Surg Endosc 2015;29(9):2794–9.
28. Ibrahim KD, Tragesser LA, Soans R, et al. Impact of racial disparities in preoperative cardiovascular evaluation and surgical outcomes in patients undergoing metabolic and bariatric surgery: A retrospective cohort analysis. J Am Heart Assoc 2022;11(11):e024499.
29. Hui BY, Roberts A, Thompson KJ, et al. Outcomes of bariatric surgery in african americans: an analysis of the metabolic and bariatric surgery accreditation and quality improvement program (MBSAQIP) data registry. Obes Surg 2020;30(11):4275–85.
30. Acevedo E, Lu X, Zhao H, Mazzei M, Sarvepalli S, Edwards MA. Outcomes in racial minorities after robotic Roux-en-Y gastric bypass and sleeve gastrectomy: a retrospective review of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database. Surg Obes Relat Dis 2021;17(3):595–605.
31. Samaan JS, Abboud Y, Yuan L, et al. Racial disparities in bariatric surgery postoperative weight loss and patient satisfaction. Am J Surg 2022;223(5):969–74.
32. Anderson WA, Greene GW, Forse RA, Apovian CM, Istfan NW. Weight loss and health outcomes in African Americans and whites after gastric bypass surgery. Obesity (Silver Spring) 2007;15(6):1455–63.
33. Cheung LK, Lal LS, Chow DS-L, Sherman V. Racial disparity in short-term outcomes after gastric bypass surgery. Obes Surg 2013;23(12):2096–103.
34. Elli EF, Gonzalez-Heredia R, Patel N, et al. Bariatric surgery outcomes in ethnic minorities. Surgery 2016;160(3):805–12.
35. Wee CC, Jones DB, Apovian C, et al. Weight loss after bariatric surgery: do clinical and behavioral factors explain racial differences? Obes Surg 2017;27(11):2873–84.
36. Edwards MA, Muraleedharan D, Spaulding A. Racial disparities in reasons for mortality following bariatric surgery. J Racial Ethn Health Disparities 2023;10(2):526–35.
37. Coleman KJ, Huang Y-C, Hendee F, Watson HL, Casillas RA, Brookey J. Three-year weight outcomes from a bariatric surgery registry in a large integrated healthcare system. Surg Obes Relat Dis 2014;10(3):396–403.
38. Coleman KJ, Brookey J. Gender and racial/ethnic background predict weight loss after Roux-en-Y gastric bypass independent of health and lifestyle behaviors. Obes Surg 2014;24(10):1729–36.
39. Smith ED, Layden BT, Hassan C, Sanchez-Johnsen L. Surgical treatment of obesity in latinos and african americans: future directions and recommendations to reduce disparities in bariatric surgery. Bariatric Surg Pract Patient Care 2018;13(1):2–11.
40. Fidler MC, Sanchez M, Raether B, et al. A one-year randomized trial of lorcaserin for weight loss in obese and overweight adults: the BLOSSOM trial. J Clin Endocrinol Metab 2011;96(10):3067–77.
41. McDuffie JR, Calis KA, Uwaifo GI, et al. Efficacy of orlistat as an adjunct to behavioral treatment in overweight African American and Caucasian adolescents with obesity-related comorbid conditions. J Pediatr Endocrinol Metab 2004;17(3):307–19.
42. Benneyworth BD, Brown K, Malik RE, Wang H, Frias JP. OR28-4 Efficacy and Safety of Tirzepatide Versus Semaglutide in a Hispanic or Latino Population: A Prespecified Subgroup Analysis of SURPASS-2. Journal of the Endocrine Society 2022;6(Supplement_1):A355–6.
43. DeSouza C, Cariou B, Garg S, Lausvig N, Navarria A, Fonseca V. Efficacy and safety of semaglutide for type 2 diabetes by race and ethnicity: A post hoc analysis of the SUSTAIN trials. J Clin Endocrinol Metab 2020;105(2).
44. O’Neil PM, Garvey WT, Gonzalez-Campoy JM, et al. Effects of liraglutide 3.0 mg on weight and risk factors in hispanic versus non-hipanic populations: subgroup analysis from scale randomized trials. Endocr Pract 2016;22(11):1277–87.
45. Davidson JA, Ørsted DD, Campos C. Efficacy and safety of liraglutide, a once-daily human glucagon-like peptide-1 analogue, in Latino/Hispanic patients with type 2 diabetes: post hoc analysis of data from four phase III trials. Diabetes Obes Metab 2016;
46. Shomali ME, Ørsted DD, Cannon AJ. Efficacy and safety of liraglutide, a once-daily human glucagon-like peptide-1 receptor agonist, in African-American people with Type 2 diabetes: a meta-analysis of sub-population data from seven phase III trials. Diabet Med 2017;34(2):197–203.
47. Aroda VR, Bauer R, Christiansen E, et al. Efficacy and safety of oral semaglutide by subgroups of patient characteristics in the PIONEER phase 3 programme. Diabetes Obes Metab 2022;24(7):1338–50.
48. Williams LK, Padhukasahasram B, Ahmedani BK, et al. Differing effects of metformin on glycemic control by race-ethnicity. J Clin Endocrinol Metab 2014;99(9):3160–8.
49. Heisler M, Faul JD, Hayward RA, Langa KM, Blaum C, Weir D. Mechanisms for racial and ethnic disparities in glycemic control in middle-aged and older Americans in the health and retirement study. Arch Intern Med 2007;167(17):1853–60.
50. Desouza C, Bain SC, Gondolf T, et al. P6271The effect of semaglutide once weekly on MACE and blood pressure by race and ethnicity: SUSTAIN 6 post hoc analysis. Eur Heart J 2019;40(Supplement_1).
51. Lu Y, Liu Y, Krumholz HM. Racial and ethnic disparities in financial barriers among overweight and obese adults eligible for semaglutide in the united states. J Am Heart Assoc 2022;11(19):e025545.
52. Elhussein A, Anderson A, Bancks MP, et al. Racial/ethnic and socioeconomic disparities in the use of newer diabetes medications in the Look AHEAD study. Lancet Reg Health Am 2022;6.
53. Wright DR, Guo J, Hernandez I. A prescription for achieving equitable access to anti obesity medications. JAMA Health Forum 2023;4(4):e230493.
54. Batsis JA, Huyck KL, Bartels SJ. Challenges with the Medicare obesity benefit: practical concerns & proposed solutions. J Gen Intern Med 2015;30(1):118–22.