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

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

Multiple supportive connections 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 support people to lose weight and improve overall health. a Recent systematic review and meta-analysis (larger study of studies) examined the effectiveness of weight management interventions provided in primary care settings, and included data from the United States, United Kingdom and Spain.

Consider weight loss support in primary care

Researchers evaluated 34 studies with adults who had a BMI greater than 25 (overweight). They looked at people who received weight-loss interventions in primary care settings. Interventions included instruction on weight management behaviors such as reduced-calorie diets, increased exercise, use of food diaries, and/or behavioral self-management techniques supported by clinic staff to set weight-related goals, problem solving, and self-increase. effectiveness.

Weight-loss interventions were conducted by telephone, Internet, e-mail, or face-to-face, and included group and/or individual communications. The research compared these types of interventions with no weight loss treatment, minimal intervention (use of print or electronic education about weight loss), or attention control instruction to resist urges or behaviors, but without specifically focusing on weight loss behavior.

Programs offered in primary care led to significant weight loss

Interventions were delivered by a variety of medical professionals (nurses, dieticians, general practitioners) and non-medical practitioners such as health coaches. Interventions lasted between one session (with patients following the program unassisted for three months) and several sessions over three years, with an average of 12 months.

Results showed that the average difference between the intervention and comparison groups (without a specific weight loss intervention) at one year was a weight loss of 5.1 pounds, and at two years it was 4 pounds for those who received weight loss interventions in primary care. There was also a mean difference in waist circumference of -2.5 cm, in favor of the one-year intervention.

Importantly, since this was a systematic review of 34 trials with a wide range of interventions, the authors were not able to determine which interventions led to the outcome.

Even a little weight loss affects health

The authors note that although the greater weight loss of 5 pounds in the intervention group may seem small, Research has shown Weight loss of 2% to 5% is associated with health benefits, including lower systolic blood pressure along with lower levels of triglycerides and glucose, which may affect heart health.

Do personal check-ins and support affect weight loss?

The study recognized that the comparison groups had fewer personal contacts than the intervention groups, and this may have played an important role in the results. More contacts between patients and caregivers resulted in more weight loss. The research suggests that programs should be developed to include at least 12 contacts (face-to-face, telephone, or a combination).

Although the study did not specify the costs of the programmes, interventions provided by non-medical personnel, with supervision and support from primary health care professionals, are likely to be less expensive. Combining practitioners may be more effective, because physicians and general practitioners will likely not have enough time to conduct 12 consultations to support a weight management program.

Previous research supports community-based behavioral interventions for weight loss

A study prepared for the US Preventive Services team and Published in 2018 I found similar results. This review reported a reduction of 5.3 pounds in participants who received weight management interventions in a variety of settings, including universities, primary care, and the community. Compared to controls, participants in the behavior-based interventions had an average greater weight loss over 12 to 18 months and less weight regain.

In the two largest trials (of the 124 identified), there was a lower likelihood of developing type 2 diabetes compared to those who did not receive weight management interventions. There was an absolute risk reduction of about 14.5% in both trials over three to nine years, which means that those who received the weight loss management intervention had a 14.5% lower chance of developing diabetes compared to the control group.

What are takeaways?

Weight management interventions delivered in primary care settings are an effective way to deliver services. Primary care practices provide good access to the community, and are often people’s first point of contact with the health care system. With our obesity epidemic growing, every effort should be considered to reach out to patients of their own weight and to provide effective and viable interventions.

What can you do?

  • Ask your PCP if his or her clinic offers weight management support programs.
  • Call your health insurance and inquire about the programs in their system to help reduce risk factors and manage weight. Ask if it’s free or discounted as part of your plan.
  • Check in your area if there are any community programs such as a YMCA, a school program, or a large center focused on wellness and weight management.

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