Diagnosing Obesity as a First Step to Weight Loss: An Observational Study

Abstract

Objective: This study aimed to explore the relationship between an obesity diagnosis and weight loss as a percentage of total body weight loss over 9 to 15 months, using electronic health record data. Methods: An observational study of 688,878 adult patients at 15 health systems with BMI ≥ 30 kg/m 2 examined the relationship between weight loss and documentation of obesity diagnosis. Multivariable logistic regression models were created using a stepwise backwards elimination procedure to identify potential predictors of weight loss. Results: Of patients with BMI ≥ 30, 44.9% had an obesity diagnosis on a claim or electronic health record problem list; 16.9% and 5.9% lost ≥ 5% and ≥ 10% of their body weight, respectively. Multivariable logistic regression models revealed a diagnosis of obesity on the same day as the initial weight (odds ratio [OR] = 1.3; CI: 1.2-1.3; P < 0.001) as a predictor of ≥ 5% total body weight loss in 9 to 15 months. Other significant predictors included an antiobesity medication prescription, female sex, diagnosis of type 2 diabetes, Medicare/Medicaid insurance, and number of ambulatory visits. Conclusions: While controlling for potentially confounding factors, documentation of an obesity diagnosis remained independently predictive of at least 5% weight loss. This suggests that documenting a diagnosis of obesity may be an important step toward engaging patients to lose weight.

Measuring What Matters: Beyond Quality Performance Measures in Caring for Adults with Obesity

“…A formal diagnosis was viewed as the first step toward changing provider and patient behaviors in terms of addressing obesity, and there is evidence to support this. 14 Documentation of an obesity diagnosis was defined as an active obesity diagnosis code on the patient's problem list in the EHR or on a claim for a visit during the reporting period, among all patients with a BMI ≥30 kg/m 2 . This measure was evaluated preliminarily as a quality performance measure, as recommended by the NQF.…”

“… 12 Other potential measures include documentation of a diagnosis of obesity; prescription for, or referral to, an evidence-based treatment or program; and change in quality of life (QOL) as assessed by patient-reported outcome measures (PROMs). 11 The documentation of an obesity diagnosis has, in fact, been associated with self-reported, 13 as well as electronic health record (EHR)-derived, 14 weight loss success. Improvements in BMI and waist circumference 15 and long-term weight loss 16 in adults have been correlated with improved health-related QOL.…”

Preliminary study on the toxicological impacts of Pinus roxburghii and Nauplius graveolens extracts on albino mice

“…The liver is a major target organ of toxicity and its injury affects the integrity of hepatocytes causing the release of membrane bound enzymes (e.g., ALT and AST), destroy hepato-biliary system thereby leading to the release of essential enzymes (e.g., ALP) [41,42]. In the current study, no significant differences were observed in serum ALT, AST and ALP levels between treated and untreated groups after oral administration of 1/10 LD50 of P. roxburghii or N. graveolens extracts.…”

Weight Can’t Wait: A Guide to Discussing Obesity and Organizing Treatment in the Primary Care Setting

“…Establishing trust and open communication between the provider and patient is essential to understanding these differences in beliefs and expectations. The observation that patients who receive a diagnosis of obesity are more likely to engage in weight management compared with their undiagnosed peers emphasizes the importance of the patient‐provider relationship (13). After obesity is diagnosed, shared decision‐making is vital to the obesity treatment process.…”