Background and Objectives: The growing prevalence of obesity in the United States and globally highlights the need for innovative strategies to provide obesity treatment in primary care settings. This report describes and evaluates the Weight Management Program (WMP), an interprofessional program in an academic family medicine clinic delivering intensive behavioral therapy (IBT) following evidenced-based guidelines. Methods: We extracted WMP participant health data from the electronic health record and evaluated retrospectively. Eligible participants completed at least four WMP visits and had a baseline weight, blood pressure, and hemoglobin A1c (HbA1c) recorded within 1 year prior to their first visit. Paired t tests were used to assess changes in, weight, HbA1c and systolic and diastolic blood pressures from baseline. Results: WMP counseled 673 patients over 3,895 visits from September 2015 to June 2019. Of these, 186 met eligibility criteria (at least four visits), with a median of eight visits (mean=11.3, SD=8.1). Participants saw an average weight decrease during program participation of 9.7 lbs (P<.001), an average decrease in HbA1c of 0.2 points (P=.004), and an average blood pressure reduction of 2.8 mmHg systolic (P=.002) and 1.9 mmHg diastolic (P=.03). One-third of participants (n=60) achieved clinically significant weight loss (>5%) at 18 months. The program has become financially sustainable through billing for preventive counseling services and a $125 out-of-pocket enrollment fee. Conclusions: WMP provides one model for primary care practices to develop a financially sustainable and evidence-based behavioral therapy weight management program for their patients with obesity. Future work will include assessment of longer-term program benefits, quality metrics, and health care costs.

Current strategies for obesity management in primary care leave many patients inadequately treated. We aimed to evaluate a comprehensive primary care clinic-based weight management program’s clinical effectiveness in a community practice setting. This is an 18 month long pre-post intervention study. We collected and analyzed anthropometric data on the patients enrolled in the community-based weight loss program. All participants received targeted lifestyle counseling, and 78% received pharmacotherapy. The primary outcomes were percent weight loss post-intervention and proportion of patients who achieved a total body weight loss of 5% or greater. Our program served 550 patients over 1952 visits from March 2019 through October 2020. Patients attended an average of 3.5 visits (SD 2.7). A total of 209 patients received adequate exposure to the program (attended at least four visits) and achieved a mean total body weight loss of 5.7% (SD 5.8%, range − 22.8% − 13.7%). Of these patients, 53.1% lost > 5% of total weight. We demonstrate that a community-based weight management program delivered by obesity medicine-trained, primary care clinicians effectively produces clinically significant weight loss in a community setting. Our approach represents a promising, scalable model for expanding access to obesity treatment for the general population.

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