The effect of a primary care-based Medical Weight Loss Program on weight loss and anthropomorphic metrics

Abstract

Background Diet and lifestyle intervention programs have been shown to be effective in decreasing obesity/overweight and many associated comorbidities in specialty research settings. There is very little information however as to the efficacy of such programs conducted in usual/typical primary care practices. We analysed effectiveness of the Medical Weight Loss Program (MWLP) designed to specifically address overweight/obesity in the setting of an urban academic primary care practice. Objective To determine whether participation in the MWLP within a general primary care setting can result in weight loss. Methods A retrospective medical chart review of patients treated in MWLP and a control group of patients with obesity receiving regular care in the general primary care setting. From the practice database (1 April 2015–31 March 2016), 209 patients (≥18 years old) who participated in the MWLP were identified; 265 controls were selected from the remaining population based on the presence of the obesity-related diagnoses. Results MWLP patients lost on average 2.35 ± 5.88 kg in 6 months compared to their baseline weight (P < 0.0001). In contrast, the control group demonstrated a trend of gaining on average 0.37 ± 6.03 kg. Having three or more visits with the MWLP provider within 6 months after program initiation was the most important factor associated with successful loss of at least 5% of the baseline weight. Weight loss also correlated with a decrease in abdominal girth. Conclusion MWLP integrated into the general primary care practice may potentially be an effective model for managing obesity and related morbidities.

Chronic diseases and comorbidities in adults with and without intellectual disabilities: comparative cross-sectional study in Dutch general practice

“…It is therefore essential to create awareness on health behaviours and engage people with ID in lifestyle alterations to decrease body weight. 33 , 40 When interventions are combined with (structural) proactive risk assessments, diseases can be diagnosed at earlier stage . 31 …”

A Primary Care–Based Weight Navigation Program

“… 36 While such interventions can support modest weight loss, they generally lack preference sensitivity and may be difficult to sustain due to use of study-specific personnel and other resources not available in most practice settings. Limited prior work has observed the outcomes of weight-focused visits with primary care–based ABOM diplomates 21 , 37 and with nondiplomate PCPs assisted by EHR-based tools to support obesity treatment decision-making. 38 …”

“…For example, a recent systematic review and metaanalysis of randomized clinical trials of weight management interventions in primary care settings reported predominant use of lifestyle counseling interventions 36. While such interventions can support modest weight loss, they generally lack preference sensitivity and may be difficult to sustain due to use of study-specific personnel and other resources not available in most practice settings.Limited prior work has observed the outcomes of weight-focused visits with primary care-based ABOM diplomates21,37 and with nondiplomate PCPs assisted by EHR-based tools to support obesity treatment decision-making 38.…”