Penn study suggests weight-loss program in primary care

Posted: November 14, 2011

Nearly a decade ago, with the deadly implications of America's obesity epidemic first sinking in, medical guidelines recommended that providers screen all adult patients and offer weight-loss help to those that need it. But with few proven techniques for family physicians to use, no training, and no insurance reimbursement, the guidance is often ignored.

The first studies showing success using realistic programs have come out only recently, with the latest reported Monday by the University of Pennsylvania. Although it is far from a magic pill - patients met quarterly with their doctor, monthly with a coach, and took a weight-loss drug or commercial meal-replacement product - participants in the Penn study lost an average 10 pounds over two years in a program that the authors said would be relatively easy for primary care providers to put into practice.

By relying heavily on lower-paid medical assistants who already worked in the offices and underwent six to eight hours of training to be coaches, it also cost less than a doctor's time would. A big unanswered question, however, is whether insurance companies would pay for any of it.

Although there are plenty of commercial weight-loss programs on the market, many don't work and most have no connection with a family's physician. Only the most highly motivated people sign up on their own.

"When patients are told by their doctor that they need to lose weight it is a much more important source of authority," said Morgan Downey, a longtime healthcare advocate and publisher of Plus, he said, the doctor may also be treating various conditions that are exacerbated by obesity, from asthma to lower back pain. "So the message there is that losing weight is not just a good virtue in itself but is related to making better the condition that we are treating today," he said.

The program studied by Penn also has the advantage of being located in the primary care provider's office.

The doctor can say, "I want you to walk down the hall and see our medical assistant," said lead author Thomas Wadden, "and I might capture you and get you started right then and there."

Wadden, director of the Center for Weight and Eating Disorders at Penn's Perelman School of Medicine, presented the findings at an American Heart Association conference in Orlando, Fla., on Monday afternoon. They were simultaneously published online in the New England Journal of Medicine.

Contact staff writer Don Sapatkin at 215-854-2617 or

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