Obesity in the GLP-1 Era: Clinical Characteristics and Prescribing Patterns in a Large Integrated Health System

Aims To characterize adults with obesity in a large integrated health system. Methods We created a cross-sectional cohort of adults with at least one body mass index (BMI) value >=30 kg/m2 in the prior 18 months, a recent in-person outpatient visit, and an assigned primary care provider. Electronic health record data were transformed into a patient-level analytic dataset and linked to neighborhood-level social determinants of health. Diagnoses, laboratory values, vital signs, and prescriptions were curated using reproducible phenotype definitions and internally reviewed vocabularies. Results The registry included 284,143 adults, of whom 48% had class I obesity. The cohort was 63% female, 27% black, and 48% lived in areas with high or very high social vulnerability. Common comorbidities included hypertension, type 2 diabetes, depression, and anxiety. HbA1c and cholesterol measurements were absent in more than 40% of the cohort during the prior two years. Overall, 22% of patients received a prescription for at least one weight loss drug in the past 2 years, including 18% who received a GLP-1 agonist approved for weight management. Conclusions This care-engaged obesity cohort was characterized by high representation of women and socially vulnerable populations, substantial cardiometabolic screening gaps, and broad adoption of GLP-1 agonists.