An endocrinologist, Dr. Leigh Perreault, expressed concern regarding the effectiveness of traditional weight management advice in medical care, noting that many medications addressed symptoms rather than underlying weight issues. This observation led to the development of a new approach.
Introduction of PATHWEIGH
Dr. Perreault and colleagues created PATHWEIGH, a structured process designed to assist patients and primary care teams with weight management. This program incorporates dedicated clinic visits for focused weight-related care, separating it from standard appointments.
Program Implementation and Results
PATHWEIGH was implemented across 56 UCHealth primary care clinics in Colorado, funded by the National Institutes of Health (NIH). The pilot study involved 274,182 patients.
Results, published in Nature Medicine by Perreault and her team, indicated that the program reduced population weight gain by 0.58 kg over an 18-month period. It also shifted the overall trend from steady weight gain to weight loss across the population. Additionally, patient participation increased the likelihood of receiving weight-related care by 23%.
Dr. Perreault stated that PATHWEIGH eliminated population weight gain across all participating primary care settings, an outcome noted as unprecedented. Consequently, obesity specialists are considering PATHWEIGH as a potential standard of care, with several health systems nationwide exploring its adoption.
Program Mechanics
PATHWEIGH functions by aligning patients and clinicians with a shared plan for weight management. Clinics displayed signs inviting patients to request appointments specifically for weight management. This request initiated an electronic health record workflow, providing patients with a survey whose responses were integrated into the clinician's notes. This process aimed to streamline visits, focusing on actionable steps rather than background information.
Impact on Care Delivery
Data collected over 18 months revealed that approximately one in four eligible patients received some form of weight-related care during the trial. While most care involved lifestyle counseling, prescriptions for anti-obesity medications doubled. The program allowed for individualized treatment plans and aimed to mitigate discomfort often associated with discussing weight in medical settings.
Public Health Significance
Experts estimate that rising obesity rates are influenced by an average population weight gain of approximately 0.5 kg per year. The program's ability to halt this increase and induce modest weight loss is considered significant for public health. Researchers observed that patients receiving direct weight-related care through PATHWEIGH experienced greater weight loss, and even those without direct interventions showed reduced weight gain compared to expected trends.
Future Expansion
Plans are underway to expand PATHWEIGH beyond Colorado. The Obesity Association is highlighting the program as a recommended care process in its developing standards for obesity care. Five health systems across seven states are also considering the adoption of PATHWEIGH as its creators work towards licensing the model.