Weight loss medications rarely prescribed in patients with MASLD: study

A survey conducted prior to resmetirom approval reports low rates of weight loss medication prescription due to low comfort potentially from lack of education despite strong beliefs that these drugs can benefit patients with metabolic dysfunction-associated steatotic liver disease (MASLD).

Hepatology and gastroenterology providers practicing in 44 states were included in this nationwide survey. A total of 747 providers received the survey, of whom 304 had complete responses (41 percent). Among those with complete responses, 260 (86 percent) work at a liver transplant centre.

Almost all respondents (96 percent) believed weight loss medications were beneficial to patients with MASLD, but 77 percent never or rarely prescribed them due to low comfort (81 percent). Among those who prescribed weight loss medications, 66 percent preferred glucagon-like peptide-1 (GLP-1) receptor agonists (RAs).

On the other hand, 63 percent had prescribed off-label medications for MASLD in the past year, with vitamin E (30 percent) and GLP-1 RAs being the most common.

The most common reasons for not prescribing weight loss medications were lack of training/unfamiliarity, cost/insurance coverage, and side-effects, which may be explained by low formal obesity education and lack of knowledge (only 33 percent of Food and Drug Administration-approved medications for weight loss were correctly identified by >50 percent of providers).

“Overall, there was reasonable provider-reported adherence to the 2023 AASLD practice guidance for MASLD,” the researchers said.