Primary Care-Led Weight Management Intervention Prevents Weight Gain and Enhances Revenue: New Research

Leigh Perreault, MD

Photo courtesy of Cardiometabolic Health Congress

A new large-scale study suggests that implementing a structured weight management program within primary care settings can effectively curb population weight gain, increase the likelihood of weight-related care, and deliver financial benefits to health systems.¹

Findings were presented at the 85^th American Diabetes Association Scientific Sessions, held June 20-23, 2025, in Chicago, IL.

The PATHWEIGH intervention was implemented across University of Colorado-affiliated primary care practices, and its effectiveness was determined with funding by the NIH, Leigh Perreault, MD, professor of medicine at the University of Colorado School of Medicine, said during a press conference at the annual meeting.²

“We were able to get build time from our internal Epic personnel to customize the electronic medical record to facilitate weight-related care. The patient would walk into their primary care clinic and see signage that would say, ‘Would you like medical assistance with your weight? If you would, then please approach the front desk and ask for a weight-prioritized visit type.’ When the patient scheduled that visit, an automated intake questionnaire would be sent to them through the patient portal 72 hours before their visit,” Perreault stated during the press briefing. “As a clinician, when I walk into the room and open my notes, I would see that immediately, and it makes the visit very fast. The note template turns into a big menu of anything we might do for weight-related care, consolidating everything into a single interface so that the provider is not clicking through the record to try to get to what they need. It also has prompts for billing. The participating health care professionals were able to get support from us for anything they did.”²

Randomization to the intervention or the usual care occurred at the clinic level, but results were reported at the patient level, according to investigators. During 4 years, 274 182 participants (mean age, 54 years; 54% women) were included in the study, of whom 84 955 were exposed to the intervention alone, 41 772 were exposed to the usual care alone, and 147 455 were exposed to both.¹

Results showed that at 18 months after the initial visit, participants in the usual care arm had a weight gain of 0.47 kg (95% CI, 0.45-0.5) and those in the intervention group had a weight loss of –0.1 kg (treatment difference, –0.58 kg; 95% CI, –0.52 to –0.61; P < .001).¹

“A counterfactual analysis indicates that the intervention eliminated population weight gain observed during usual care,” Perreault said during the press briefing.²

Importantly, the approach increased the likelihood that participants with overweight or obesity received weight-related care. An intention-to-treat analysis revealed a 23% increase in the odds of receiving such care during the intervention period (odds ratio, 1.23; 95% CI, 1.16-1.31; P < .001). Prior to the intervention, only 25% of adults with a BMI >25 kg/m² had received discernible weight-related services over 4 years, defined by provider use of relevant ICD-10 billing codes, counseling, referrals, or obesity pharmacotherapy.¹

The study's counterfactual analysis showed that weight loss was greater among those receiving weight-related care during the intervention than in usual care settings, further supporting the program’s efficacy. Moreover, the intervention did not impose additional provider time; a limited number of interviews and recorded visits indicated negligible incremental costs.¹

From a financial perspective, the program demonstrated considerable benefits. Providers utilized weight-related ICD-10 codes for over 180 000 encounters during the intervention period, up from approximately 41 772 in usual care, resulting in more than $15 million in additional revenue accrued by the health systems involved.¹

"More weight-related care during the intervention translated into little cost and more revenue for the health system," the authors noted. These findings suggest that integrating structured weight management initiatives into primary care can be both clinically beneficial and financially sustainable.¹

Despite these advancements, the study highlights ongoing barriers, noting that only a quarter of participants with overweight and obesity received discernible weight-related care over 4 years. The authors advocate for broader implementation of such interventions to combat the persistent obesity epidemic and improve patient outcomes.¹

“PATHWEIGH is not a car on the road, it is the road,” Perrault said during the press conference. “It is the unifying road for all weight-related care in the same place.”²

References:

1. Perreault L, et al. Symposium – PATHWEIGH trial – Building the highway for weight management in primary care. Presented at: American Diabetes Association Scientific Sessions; June 20-23, 2025; Chicago.
2. American Diabetes Association Press Room. 6-20 press conference. June 20, 2025. Accessed June 23, 2025.