Trends in Glucagon-Like Peptide-1 Agonist Use and BMI Among Obese Adults With Type 2 Diabetes: Analysis of the 2010-2015 National Ambulatory Medical Care Survey (NAMCS), Adjusted for Cardiovascular Comorbidity

Background and objective Glucagon-like peptide-1 (GLP-1) receptor agonists are increasingly used to manage type 2 diabetes (T2D) and promote weight loss; however, their real-world use remains undercharacterized. The objective of this study was to assess trends in GLP-1 agonist prescriptions and their association with BMI among obese adults with T2D in US outpatient settings. Methods We analyzed data from the National Ambulatory Medical Care Survey for the years 2010-2015. Adults diagnosed with both obesity and T2D were included. GLP-1 use was identified using Multum drug codes. Weighted descriptive statistics, design-based F-tests, t-tests, and linear regression were used to assess associations between GLP-1 use and BMI, adjusting for demographics, insurance, cardiovascular disease, and year. Results Of 121,266 adult outpatient visits analyzed, only 0.13% involved a GLP-1 prescription, reflecting limited use during the study period. GLP-1 users had a significantly higher BMI compared with nonusers (β = 5.98, p < 0.001). Use of GLP-1s showed no consistent increase over time. Several factors, including age, sex, race/ethnicity, insurance type, and cardiovascular comorbidity, were significantly associated with BMI. Conclusions GLP-1 agonists were underutilized between 2010 and 2015 and were more likely to be prescribed to patients with higher BMI. These findings underscore the need to expand access to and guideline-based prescribing of these agents to optimize diabetes and obesity care.