Behavioral weight loss interventions: do they work in primary care?

Multiple supportive relationships in community settings can help people lose weight.

Achieving and maintaining a healthy weight is a major health issue not only in the United States but in many countries around the world. Governments are looking to identify the most effective services to help people lose weight and improve overall health. A A recent systematic review and meta-analysis (a large case study) examined the effectiveness of weight management interventions delivered in primary care settings, and included data from the United States, the United Kingdom, and Spain.

Looking at weight loss support in primary care

Researchers reviewed 34 studies with adults with A Body mass index Over 25 (overweight). They looked at people who received weight loss interventions in primary care settings. The interventions included instruction in weight management behaviors such as low-calorie diet, increased physical activity, use of a food diary, and/or behavioral self-management approaches to weight-related goal setting, problem solving, and support for self-enhancement by clinic staff. Effectiveness.

Weight loss interventions were conducted by telephone, Internet, email, or face-to-face and included group and/or individual interactions. The study compared these types of interventions to weight loss therapy, minimal intervention (using printed or electronic education about weight loss), or attention control instruction to deal with compulsions or behavior, but specifically focusing on weight loss behavior.

Primary care programs have resulted in significant weight loss

Interventions are delivered by a variety of medical professionals (nurses, dieticians and general practitioners) and non-medical professionals such as health coaches. The measures were between one session (patients who followed the program without assistance for three months) and several sessions over three years, with an average of 12 months.

The results showed that the mean difference between the intervention and comparison (no specific weight loss intervention) groups at one year was 5.1 pounds of weight loss, and at two years it was 4 pounds for those who received weight loss interventions in primary care. At one year, there was a mean difference of -2.5 cm in waist circumference in favor of the intervention.

Importantly, this was a systematic review with a wide range of 34 trials, the authors could not identify which intervention produced particular results.

Even a small weight loss can affect your health.

Although the 5 kg weight loss in the intervention group seems small, the authors Research has shown. A 2% to 5% weight loss is associated with health benefits, including lower systolic blood pressure and reduced triglyceride and glucose levels, which can affect heart health.

Do personal checks and support affect weight loss?

The study found that the comparison groups had less interpersonal communication than the intervention groups, which played a significant role in the findings. A greater number of contacts between patients and providers led to greater weight loss. Research shows that programs should be designed to include at least 12 contacts (face-to-face, telephone or a combination).

Although the study did not determine the cost of the programs, interventions delivered by non-physicians with the supervision and support of primary health professionals may be less expensive. Physicians and general practitioners do not have time for 12 consultations to support a weight management program, so a combination of professionals can be very effective.

Prior research supports community-based behavioral interventions for weight loss

A study prepared for the US Preventive Services Task Force and Published in 2018 He got the same results. This review found a 5.3 pound reduction in participants who received weight management interventions, including university, primary care and community settings. Compared to controls, participants in behavior-based interventions had lower mean weight loss and weight regain over 12 to 18 months.

In the two largest trials (124 participants), the risk of developing type 2 diabetes was reduced compared to those who did not receive weight management interventions. In both trials, there was an absolute risk reduction of 14.5% over three to nine years, meaning that those who received the weight loss management intervention had a 14.5% reduced risk of developing diabetes compared to the control group.

What is the take?

Weight management interventions delivered in primary care settings are an effective means of delivering services. Primary care practices provide a good connection to the community, and are often the first point of contact for people with the health care system. With the growing obesity epidemic, every effort should be considered to connect with patients struggling with their weight and provide effective and efficient interventions.

What can you do?

• Ask your PCP if their practice or clinic offers weight management programs.
• Contact your health insurance and ask about programs they have in place to help reduce risk factors and manage weight. Ask if they are exempt or deductible as part of your plan.
• Check for community-based programs in your area, such as a YMCA, a school-based program, or a senior center focused on health and weight management.