Neither is a magic pill. In the Penn study, adult patients met quarterly with their regular doctor, monthly with a coach, and took a weight-loss drug or commercial meal-replacement product. In the Hopkins study, regular doctor visits were supported by an interactive web site plus coaching in person or by phone, Internet and email.
In both studies, patients had lost an average of more than 10 pounds after two years. That modest amount, experts said, can be enough to prevent the development of serious health conditions such as diabetes.
And by relying heavily on lower-paid "coaches" with limited training, both programs likely cost less than a doctor's time would. A big unanswered question, however, is whether insurance companies would pay for any of it.
Although some commercial programs like Weight Watchers are effective, 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 downeyobesityreport.com. Plus, he said, the doctor may also be treating various conditions, from asthma to back pain, that are exacerbated by obesity. "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.
Even if a physician makes a referral to a commercial program, many patients never show up, said Thomas Wadden, lead author of the Penn study.
His program was located in physicians' own offices. At the end of an appointment the doctor can say, "I want you to walk down the hall and see our medical assistant," said Wadden, "and I might capture you and get you started right then and there."
