Pragmatic Online Program tied to Long-Term Success in Primary Care Weight Loss: JAMA

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Obesity is a prevalent health concern, and effective weight loss interventions are crucial. However, sustaining weight loss over the long term poses significant challenges. Pragmatic and scalable interventions are needed to address this issue, especially in primary care settings where patients often seek guidance for weight management. A recent clinical trial aimed to evaluate the long-term effectiveness of an automated, online, behavioral obesity treatment program in primary care and to compare different weight loss maintenance approaches.

This study was published in the journal JAMA Internal Medicine by J. Graham and colleagues. To assess the effectiveness of an automated, online, behavioral obesity treatment program over 12 and 24 months in primary care patients with overweight or obesity and to compare various weight loss maintenance approaches.

A randomized clinical trial recruited participants from a Rhode Island primary care network and offered a 3-month weight loss program followed by randomization to one of three 9-month maintenance programs. Data were collected from electronic medical records and analyzed for weight change outcomes.

The key findings of the study were:

  • Among 540 participants, the mean 3-month weight loss was 3.60 kg.

  • At 12 months, participants in the monthly and refresher maintenance groups regained significantly less weight compared to the control group (0.37 kg and 0.45 kg vs. 1.28 kg, respectively).

  • This trend persisted for 24 months, indicating sustained benefits of maintenance interventions.

  • In the per-protocol analysis of 253 participants, mean weight loss at 12 months was 6.19 kg, with less weight regained in the monthly and refresher maintenance groups compared to the control group.

The study demonstrates that a 12-month automated, online, behavioral obesity treatment program, coupled with active maintenance interventions, produces clinically significant weight loss over 2 years in primary care patients with overweight or obesity. These findings emphasize the importance of ongoing maintenance interventions to prevent weight regain and highlight the potential of scalable, technology-based approaches in addressing obesity in primary care settings.

Reference:

Thomas JG, Panza E, Goldstein CM, et al. Pragmatic Implementation of Online Obesity Treatment and Maintenance Interventions in Primary Care: A Randomized Clinical Trial. JAMA Intern Med. Published online March 11, 2024. doi:10.1001/jamainternmed.2023.8438




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