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In the national cohort, 577,491 records with an obesity or control metformin prescription and adequate weight documentation were identified. The most effective pharmacotherapy in the national cohort was phentermine/topiramate (-0.0931 ± 0.0198 kg/wk difference), followed by liraglutide, lorcaserin, and orlistat. Obesity pharmacotherapy is effective in achieving clinically meaningful weight loss in veterans as part of an integrated care approach. Obesity pharmacotherapy is effective in achieving clinically meaningful weight loss in vete