Trends in Use of Obesity Medications and Metabolic and Bariatric Surgery Among All of Us Participants From 2003 to 2023.

OBJECTIVE: This study aimed to evaluate the trends in antiobesity medication (AOM) and metabolic and bariatric surgery (MBS) use relative to the 2013 American Medical Association (AMA) declaration of obesity as a chronic disease and semaglutide approval in 2021 in the United States. METHODS: We employed a repeated cross-sectional design to analyze national electronic health records (EHR) of US adults (≥ 18 years) with obesity (BMI ≥ 30 kg/m) or overweight (BMI ≥ 27 kg/m) with ≥ 1 comorbidity for AOM and those with BMI ≥ 35 kg/mfor MBS, using the All of Us dataset. We used interrupted time-series models to evaluate trends from January 1, 2003, to October 1, 2023. RESULTS: AOM rates increased by 0.31%/year (95% CI, 0.25%, 0.37%) after 2013 and further increased by 1.42%/year (95% CI, 1.16%, 1.68%) after 2021. MBS use declined by 0.10%/year (95% CI, -0.15%, -0.04%) before 2013. Semaglutide approval was not associated with MBS use decline after 2021. After 2013, patients with BMI ≥ 40 kg/mexperienced a larger increase in AOM use (0.50% [95% CI, 0.40%, 0.61%]) vs. < 40 kg/m(0.25%/year [95% CI, 0.20%, 0.30%]) and stable MBS use. CONCLUSIONS: The declaration increased AOM use and, to a lesser extent, MBS use. Semaglutide approval increased AOM use but had no impact on MBS use.