Obesity Drug Trials Lack Diversity in Sex, Race, and BMI Reporting

The global prevalence of obesity continues to rise, making the development of effective anti-obesity medications a critical public health priority. Clinical trials are essential for evaluating the safety and efficacy of these treatments. However, the generalizability of trial results depends heavily on how well the study populations reflect the diversity of individuals living with obesity. This systematic review addresses the critical knowledge gap regarding the representation of sex, race, and BMI characteristics in clinical trials for obesity medications over the past three decades.

The review revealed significant gaps in demographic reporting and representation within obesity medication trials. While 98% of trials reported participant sex, only 65% provided data on race or ethnicity, and a mere 40% reported baseline BMI categorized beyond a simple mean. Furthermore, women were consistently overrepresented, constituting 68% of participants on average, despite a more balanced prevalence of obesity across sexes in the general population. Racial and ethnic minority groups, particularly African American and Hispanic individuals, were significantly underrepresented, often making up less than 5% of total enrollment in trials conducted in regions with higher diversity. > A staggering 72% of trials failed to report efficacy or safety outcomes stratified by race/ethnicity, severely limiting the understanding of treatment effects across diverse populations. This lack of stratified data means potential differential responses to medications based on genetic or environmental factors remain largely unknown.