Weight Management Treatments Underused among Primary Care Patients with Obesity: Daily Dose

Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

Last week, we reported on findings from a study published in JAMA Network Open that examined weight status and weight management treatment (WMT) use among primary care patients with obesity and analyzed the associations between WMT and weight trajectories.

The study

Investigators analyzed the electronic health records of 146 959 adults (mean age, 49 years; 56.9% women) who had weight measurements taken in 2017 or 2019. Trajectory analysis exposures were WMT: nutrition counseling, very low-calorie meal replacement, antiobesity medications, and bariatric surgery.

The findings

The cohort was eventually narrowed down to 138 682 participants, and among those, obesity prevalence increased from 39.2% in 2017 to 40.7% in 2019, whereas WMT use among patients with obesity increased from 5.3% to 7.1%.

In a multistate model that examined weight trajectories of 10 180 patients with obesity, researchers found that the 1-year probability of ≥5% weight loss without WMT exposure was 15.6% (95% CI, 14.3%-16.5%). In comparison, the 1-year probability of ≥5% weight loss was:

• 23.1% (95% CI, 21.3%-25.1%) with nutrition counseling;

• 27.8% (95% CI, 25%-30.5%) with antiobesity medications;

• 54.6% (95% CI, 46.5%-61.3%) with meal replacement; and

• 93% (95% CI, 89.7%-95%) with bariatric surgery.

Authors' comment

"Health systems and insurers should consider novel strategies to enhance preference-sensitive use of WMT to optimize achievement of 5% or greater weight loss among individuals and populations with obesity."

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