Health Coaching Integration into Primary Care for the Treatment of Obesity

Abstract

Obesity (and its related comorbidities) is one of the fastest-growing health concerns facing the United States and shows no sign of abating.1 The Centers for Disease Control and Prevention calculated that nearly 36% of American adults were obese in 2010 and estimates that this number will reach 44% by 2018.The current standard of care for the management of patients with obesity in primary care is often a general recommendation by the physician to lose weight through improved nutrition and increased physical activity. Educational materials may be provided along with a referral to a dietician, nutritionist, or weight management program. Health coaching as an obesity intervention has yet to be fully integrated into primary care practice but has proven to be effective in corporate wellness and behavioral weight loss programs.2–5

Efficacious Approach to Integrating Health and Wellness Coaching Into the Clinical Care for Weight Management: A Systematic Review and Proposal

“…Literature extensively shows health and wellness coaching is efficacious for weight management in a variety of primary care settings for obese and overweight patients ranging from children to adults (Table 1). Coaching has been successfully implemented in the care of children [44,45] , adolescents [46] , and adults [10,[47][48][49][50][51][52] . Coaching has also been incorporated into patient care with a variety of health professionals.…”

“…Coaching has also been incorporated into patient care with a variety of health professionals. This has been achieved with coaches plus PCP collaboration [8,10,4244,53] , with coaches alone [31,[44][45][46][47][48][49][50]52,53] , with physician coaches [34,46] , and with auxiliary health professional coaches such as Medical Assistants [38,47,54] , Nurse Practitioners [50] , and Registered Dietician Nutritionists [31] .…”

“…As to a method of implementing coaching in a clinical care process, this has been done for groups of patients [10] , parent-child groups [44,45] , via one-on-one sessions [10,31,34,38,[45][46][47][48][49][50]52] . Coaching was also integrated in-person [10,31,34,[46][47][48][49][50][51]54] and remotely via telephone [10,45,49,52] , a study-specific website [10] , email support [10,14] , as well as general mail, text message, and virtual video visit [45] .…”

“…The dosage of coaching interventions offered to patients varied as well including low-intensity or less than monthly coaching [31,4547,50] , moderate-intensity or at least monthly coaching [10,31,4951,54] , high-intensity or at least weekly [10,34,44,[46][47][48][49][50][51][52] , or with a combination of these throughout the intervention [10,31,47] . Length of intervention ranged from approximately four months [34,44,46] , six months [47,52,54] , approximately one year [45,[48][49][50] , and multiple years [10,31,51] .…”

Tipping the scales: Provider perspectives on a multi-disciplinary approach to obesity

“…50 Health coaching as an obesity intervention has proven to be effective in corporate wellness and behavioral weight loss programs. 51 All studies employed MI, food diaries, and selfmonitoring of weight as behavioral therapies (Table 1). In addition, all studies included accountability for whether participants attended individual or group visits as means to increase weight loss success.…”