Physician-Guided Weight Loss Program in Primary Care Shows Promising Results

A physician-guided weight loss program can be beneficial for obese individuals in a primary care setting even with limited resources, according to study results presented at the 30th Annual Scientific and Clinical Congress of the American Association of Clinical Endocrinologists (ENVISION 2021).

A team of investigators recruited 300 adults (85.0% women, n=255; mean age 48.1±13.5 years with a body mass index [BMI] >30 kg/m²) to participate in this study from October 2018 to January 2021. All participants joined a university-based program for weight loss that took place 1 day per week. Participants had an average of 2.3 comorbidities, including diabetes, prediabetes, hyperlipidemia, hypertension, sleep apnea, cardiovascular disease, malignancy, arthritis, depression, and polycystic ovary syndrome. A primary care physician trained in obesity medicine offered weight loss interventions that included motivational interviews, counseling on diet and exercise, behavioral training, and therapy for weight loss. The percentage of weight change between 2 consecutive visits less than 90 days apart was used to assess outcomes. Chi-square or t-test was used for statistical analysis.

Significant weight loss was more likely among those who stayed in the program longer, with 51% (n=158) of participants only attending 1 visit. Among those with 2 to 3 visits, 16.1% lost 5% of their body weight, and 4.3% lost 10% of their body weight. Among those who visited 5 or more times, 57.7% lost 5% of their body weight, and 42.3% lost 10% (P <.0001). At approximately 200 days, 60% of the engaged study participants achieved a 5% weight loss, and at 350 days 40% achieved a 10% weight loss. Among those who lost 5% of their body weight, average glycated hemoglobin (A_1c) was reduced from 6.4% to 5.8% by their last visit.

The study researchers concluded that such a model “can be successfully introduced in the primary care setting with proper training even with limited resources and without [a] multidisciplinary team.” Although most participants lost 10% of their weight in a year, the researchers indicated that just a “5% weight reduction can significantly decrease hemoglobin A_1c in patients with diabetes and prediabetes.” The study researchers concluded that “More primary care physicians should be trained in obesity medicine” and receive support to schedule more frequent visits.

Reference

Sliwinska A, Ramanan S, Niranjan V, Wu H, Chen F, Maheshwari N. The weight of time: achievements and challenges of a physician-led weight loss program in a primary care setting. Presented at: 2021 AACE Virtual Annual Meeting, May 26-29, 2021.