Evidence synthesis · §4
Distribution of access to obesity pharmacotherapy — summary of findings
Outcome-by-outcome summary with effect, certainty and the reason for each downgrade.
§4Summary of findings
§4.1Summary of findings
Table 7. Summary of findings for Distribution of access to obesity pharmacotherapy.
| Outcome | Participants (studies) | Effect as reported | Certainty | Reason for downgrade |
|---|---|---|---|---|
| Percentage change in body weight from baselineThe outcome the Institute designates as anchor for this indication. | 29,508 (24) | Low certainty evidence indicates that eligibility under the pivotal trial criteria substantially exceeds treated prevalence in every jurisdiction for… | Low | indirectness, publication bias |
| Discontinuation for adverse eventsReported as a summary-of-findings row rather than in a tolerability annex, following a public submission. | 27,172 (23) | Reported per contributing trial; see the included-studies table | Low | risk of bias |
| Serious adverse eventsEvent counts are low; the estimate is imprecise by construction. | 25,939 (23) | Reported per contributing trial; see the included-studies table | Very low | indirectness, imprecision, publication bias |
| Any adverse eventAscertained by spontaneous report in the contributing trials. | 27,341 (24) | Reported per contributing trial; see the included-studies table | Very low | risk of bias, imprecision, publication bias |
| Proportion achieving ≥5 %, ≥10 %, ≥15 % and ≥20 % weight reductionA secondary outcome for this indication. Its hierarchical position within each contributing trial is recorded on that trial's abstract where the Institute holds it. | 15,329 (23) | Reported as a secondary outcome in a subset of contributing trials | Very low | indirectness, imprecision |
| Change in waist circumferenceA secondary outcome for this indication. Its hierarchical position within each contributing trial is recorded on that trial's abstract where the Institute holds it. | 17,331 (23) | Reported as a secondary outcome in a subset of contributing trials | Very low | risk of bias, inconsistency, indirectness |
| Certainty ratings describe confidence in the effect estimate for the stated outcome. They are not recommendations and do not transfer between outcomes. | ||||
§4.2Forest plot
Study estimatePooled estimate
§4.3Certainty assessment for the anchor outcome
Table 8. Reasoning recorded against each certainty domain for the anchor outcome.
| Domain | Rating | Reasoning |
|---|---|---|
| Risk of bias | No concern | No serious concern identified in this domain. |
| Inconsistency | No concern | No serious concern identified in this domain. |
| Indirectness | Serious | The outcome is a surrogate whose relationship to the clinical outcome is unvalidated for this indication. |
| Imprecision | No concern | No serious concern identified in this domain. |
| Publication bias | Serious | The evidence base is small, recent and wholly sponsor-generated. |
| Overall: Low certainty. Confidence in the effect estimate is limited. The true effect may be substantially different from the estimate. | ||
Compound Evidence Institute · CEI-ES-035/4 · https://compoundevidence.com/syntheses/obesity-pharmacotherapy-access-equity/summary-of-findings/ · retrieved 30 July 2026