TABLE 1.
Trends in obesogenic and total prescription medication usea among adults, by therapeutic classb, United States, 1999–2018
| Survey year | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| 1999–2000, n = 4,433 |
2001–2002, n = 5,024 |
2003–2004, n = 4,731 |
2005–2006, n = 4,766 |
2007–2008, n = 5,704 |
2009–2010, n = 6,054 |
2011–2012, n = 5,317 |
2013–2014, n = 5,585 |
2015–2016, n = 5,470 |
2017–2018, n = 5,256 |
Trendc | |
| Anticonvulsants, % (95% CI) | |||||||||||
| Obesogenic | 0.8 (0.4–1.3) | 1.5 (1.1–1.9) | 1.9 (1.4–2.5) | 1.7 (1.2–2.3) | 2.5 (1.9–3.3) | 2.6 (2.2–3.0) | 2.4 (1.9–3.0) | 3.5 (2.7–4.4) | 4.2 (3.5–4.9) | 4.5 (3.4–5.8) | Increasing |
| Total | 2.3 (1.7–2.9) | 3.4 (2.5–4.4) | 4.7 (3.7–5.8) | 4.3 (3.6–5.1) | 5.2 (4.3–6.2) | 5.3 (4.8–5.9) | 5.4 (4.4–6.4) | 7.1 (6.3–8.0) | 7.4 (6.3–8.7) | 8.2 (6.9–9.7) | Increasing |
| Proportion obesogenic | 34.4 (20.2–50.9) | 43.9 (37.6–50.4) | 41.4 (34.9–48.2) | 39.2 (29.7–49.4) | 48.7 (42.2–55.2) | 49.0 (42.9–55.1) | 45.4 (36.4–54.5) | 49.4 (38.2–60.6) | 56.0 (48.2–63.6) | 55.0 (46.9–63.0) | Increasing |
| Antidepressants, % (95% CI) | |||||||||||
| Obesogenic | 2.3 (1.9–2.9) | 3.1 (2.4–4.0) | 3.2 (2.7–3.7) | 2.2 (1.8–2.6) | 2.2 (1.9–2.6) | 1.9 (1.3–2.7) | 2.4 (1.9–3.0) | 2.4 (1.9–3.1) | 1.8 (1.2–2.5) | 2.7 (2.0–3.7) | Nonsignificant |
| Total | 7.3 (6.2–8.5) | 9.3 (8.1–10.6) | 11.2 (9.9–12.7) | 11.4 (10.3–12.6) | 12 (10.4–13.7) | 10.8 (9.3–12.6) | 12.9 (10.4–15.6) | 15.2 (13.3–17.1) | 13 (11–15.2) | 14.5 (12.3–16.9) | Increasing |
| Proportion obesogenic | 32.1 (26.2–38.5) | 33.4 (25.9–41.6) | 28.2 (23.8–32.9) | 19.0 (15.6–22.6) | 18.4 (15.9–21.3) | 17.2 (12.1–23.3) | 18.5 (14.2–23.3) | 16.1 (12.5–20.1) | 13.8 (10–18.4) | 18.8 (14–24.5) | Decreasing |
| Antidiabetics, % (95% CI) | |||||||||||
| Obesogenic | 4.0 (3.3–4.9) | 4.3 (3.6–5.0) | 5.4 (4.5–6.5) | 4.9 (4.1–5.8) | 5.8 (4.6–7.2) | 5.3 (4.5–6.1) | 5.4 (4.6–6.3) | 5.2 (4.5–6.0) | 5.2 (4.3–6.2) | 5.7 (5.1–6.4) | Increasing |
| Total | 4.8 (3.9–5.9) | 5.3 (4.4–6.2) | 6.4 (5.4–7.5) | 6.4 (5.5–7.4) | 7.7 (6.2–9.3) | 7.8 (6.8–8.8) | 8.3 (7.2–9.5) | 9.5 (8.4–10.7) | 10.3 (8.9–11.8) | 10.9 (10–11.8) | Increasing |
| Proportion obesogenic | 82.9 (77.5–87.5) | 80.8 (72.9–87.3) | 84.7 (77.5–90.3) | 76.9 (71.7–81.5) | 75.6 (70–80.5) | 67.9 (62.1–73.4) | 64.7 (61–68.3) | 54.7 (51.2–58.2) | 50.3 (45–55.7) | 52.5 (46.9–58.0) | Decreasing |
| Anti-inflammatories, % (95% CI) | |||||||||||
| Obesogenic | 2.1 (1.7–2.7) | 1.8 (1.3–2.5) | 1.5 (1.1–2.0) | 1.6 (1.1–2.3) | 1.3 (1.0–1.6) | 1.2 (0.8–1.6) | 1.5 (1.1–1.9) | 1.5 (1.1–2.0) | 1.5 (1.0–2.0) | 1.8 (1.4–2.2) | Decreased from 1999–2000 to 2009–2010 and then increased from 2009–2010 to 2017–2018 |
| Total | 10.0 (8.4–11.9) | 9.9 (8.6–11.4) | 12.9 (11.4–14.6) | 8.4 (7.4–9.5) | 8.0 (6.5–9.7) | 8.1 (7.0–9.2) | 7.2 (5.7–9.0) | 8.6 (7.6–9.7) | 7.7 (6.4–9.2) | 8.9 (7.7–10.2) | Decreasing |
| Proportion obesogenic | 21.3 (18.4–24.4) | 18.4 (14.0–23.6) | 11.6 (8.4–15.6) | 19.3 (13.1–26.8) | 16.0 (11.7–21.0) | 14.6 (10.5–19.6) | 20.8 (17.1–24.9) | 17.2 (12.5–22.8) | 18.8 (14.1–24.2) | 20.0 (15.3–25.5) | Nonsignificant |
| Antipsychotics, % (95% CI) | |||||||||||
| Obesogenic | 0.6 (0.2–1.3) | 0.8 (0.4–1.4) | 0.7 (0.3–1.1) | 0.9 (0.6–1.3) | 0.9 (0.6–1.3) | 0.8 (0.5–1.2) | 1.0 (0.6–1.4) | 1.0 (0.7–1.3) | 1.0 (0.7–1.4) | 1.0 (0.7–1.3) | Nonsignificant |
| Total | 1.1 (0.6–1.9) | 1.1 (0.6–1.7) | 1 (0.5–1.8) | 1.4 (1–1.8) | 1.4 (0.9–2.0) | 1.2 (0.9–1.6) | 1.6 (1.1–2.1) | 1.6 (1.2–2.1) | 1.8 (1.2–2.5) | 1.6 (1.3–2.0) | Increasing |
| Proportion obesogenic | 58.8 (33.3–81.2) | 75.2 (58.2–87.9) | 66.2 (39.9–86.8) | 69.4 (54.6–81.8) | 64.3 (51.1–76.1) | 66.0 (51.1–78.9) | 62.5 (46.3–76.9) | 59.7 (46.1–72.2) | 54.7 (39.2–69.6) | 61.0 (49.6–71.5) | Nonsignificant |
| Beta-blockers, % (95%CI) | |||||||||||
| Obesogenic | 5.1 (4.2–6.2) | 5.6 (4.5–6.9) | 8.1 (7.2–9.1) | 9.4 (7.6–11.5) | 8.7 (7.7–9.6) | 8.9 (7.7–10.2) | 8.3 (6.5–10.4) | 8.0 (7.0–9.1) | 7.8 (6.7–9.1) | 9.8 (8.7–11.1) | Increased from 1999–2000 to 2003–2004 and was then stable from 2003–2004 to 2017–2018 |
| Total | 6.1 (5.1–7.2) | 6.8 (5.5–8.3) | 9.5 (8.5–10.6) | 10.9 (9.1–12.9) | 10.1 (9.1–11.3) | 11.4 (9.8–13.2) | 10.6 (8.6–12.9) | 11.2 (10.2–12.3) | 10.2 (8.8–11.8) | 12.2 (11.2–13.3) | Increased from 1999–2000 to 2003–2004 and then increased at a lower rate from 2003–2004 to 2017–2018 |
| Proportion obesogenic | 83.9 (76.5–89.7) | 82.1 (74.9–88.0) | 85.5 (80.3–89.7) | 86.5 (80.8–91.0) | 85.3 (82–88.3) | 77.7 (73.6–81.5) | 78.7 (72.3–84.2) | 71.7 (66.3–76.6) | 76.6 (70.9–81.6) | 80.7 (73.1–86.8) | Decreasing |
| Any medication, % (95% CI)b | |||||||||||
| Obesogenic | 13.2 (11.3–15.3) | 14.3 (12.4–16.3) | 17.3 (15.8–18.9) | 17.5 (15.1–20.0) | 17.6 (15.7–19.7) | 16.9 (15.3–18.5) | 17.2 (15.1–19.4) | 17.7 (16.0–19.6) | 17.0 (15.4–18.8) | 20.3 (18.5–22.2) | Increasing |
| Total | 22.6 (20.2–25.1) | 24.4 (22.4–26.6) | 30.8 (28.4–33.3) | 29.4 (26.9–32.0) | 29.7 (27.0–32.5) | 29.7 (27.3–32.2) | 31.0 (27.5–34.8) | 33.5 (31.5–35.4) | 32.1 (29.7–34.6) | 34.8 (32.3–37.3) | Increasing |
| Proportion obesogenic | 52.2 (48.5–55.9) | 53.3 (49.3–57.2) | 53.7 (51.3–56.2) | 57.0 (52.9–61.1) | 56.8 (53.5–60.1) | 54.8 (51.1–58.4) | 52.4 (48.7–56.2) | 50.2 (46.2–54.2) | 51.2 (47.4–54.9) | 55.8 (50.7–60.9) | Nonsignificant |
Note: For each therapeutic class, the prevalence estimates for obesogenic medications include adults who take at least one obesogenic medication and may also take nonobesogenic medications in the same therapeutic class.
a
Obesogenic and total percentages indicate prevalence of use among the US adult population. Proportion obesogenic indicates the relative proportion within each class.
b
Only selected therapeutic classes that contain obesogenic medications.
c
Linear trends are significant at p < 0.05. Linearity was evaluated using orthogonal polynomial logistic regression that included the 2-year survey cycle as a continuous variable. Nonlinear trends were then evaluated with Joinpoint software, and any significant Joinpoint result was confirmed using piecewise regression.