Adding obesity experts to primary care clinics improves patients’ weight loss outcomes

Giving high-risk patients access to an obesity specialist through their regular primary care clinic increased their chances of receiving at least one evidence-based weight-management treatment, and led to more weight lost in just a year, a new University of Michigan study finds.

Primary care clinicians commonly struggle to help patients develop an individualized weight-management treatment plan during short clinic visits. Previous U-M research showed that most primary care patients with obesity do not lose at least 5% of their body weight, a goal that’s been shown to reduce obesity-related health risks.

That’s why U-M’s academic medical center, Michigan Medicine, developed the Weight Navigation Program, which teams up patients with obesity and their primary care provider with a board-certified obesity specialist.

The new study evaluating results from it is published in JAMA Network Open by the multidisciplinary team that launched the WNP in fall 2020.

The new study shows that on average, patients who enrolled during the first year of the program lost about 12 pounds, or about 4.4% of their body weight, in the year after they received an individualized obesity treatment plan from an obesity specialist.

That’s compared with very little weight lost by patients similar to the WNP patients who went to a similar U-M primary care clinic that didn’t yet offer the program.

On average, all the patients started with a body mass index (BMI) around 40 kg/m2. To qualify for WNP, patients have to have a BMI above 30 kg/m2 and have at least one weight-related health condition, such as high blood pressure, sleep apnea, type 2 diabetes, or high cholesterol.

Over 40% of those in the WNP lost at least 5% of their body weight, a goal that’s been shown to reduce obesity-related health risks. In comparison, less than 20% of similar patients not in the WNP lost at least 5% of their body weight. In addition, 22% of patients in the WNP lost at least 10% of their body weight compared to less than 4% of similar patients.

The authors say the study suggests that the WNP approach should be tested in a larger clinical trial.

Meanwhile, the WNP is now available to all eligible adult patients who receive primary care through U-M Health clinics, acting as a gateway to multiple treatment options. It’s part of a wide range of weight management programs available by referral in multiple areas of U-M Health.

“The WNP is based in the idea that safe and effective obesity care can be integrated into the primary care settings where most Americans with obesity receive the vast majority of their care,” said Dina Hafez Griauzde, M.D., M.Sc., first author of the study and an internal medicine assistant professor at the U-M Medical School. “Having an obesity specialist work as part of a collaborative team to evaluate patients, help them understand their options, including potential costs, and act as a gateway to specialized care and primary care follow-up, is a model that we hope others will adopt.”

Senior author, Andrew Kraftson, M.D. is an endocrinologist who specializes in obesity medicine But a shortage of such specialists means that programs such as WNP are needed to extend their reach.

The WNP builds on the previous success of other kinds of chronic disease programs that involve closer partnership between specialists and primary care providers. One key difference: two-thirds of current obesity medicine specialists are also primary care physicians, including Griauzde and several of her co-authors.

A Primary Care–Based Weight Navigation Program, JAMA Network Open, doi:10.1001/jamanetworkopen.2024.12192