Intellihealth: Population Health Guidelines + Online Support Improves Weight Loss

Even small amounts of weight loss, even 3%-5% of body weight, can provide significant health benefits to individuals with overweight and obesity.

WeightControl.com Interview with:
Dr. Louis Aronne, MD, FACP
Chief Medical Officer, Intellihealth
Medical Director, Comprehensive Weight Control Center,
Weill Cornell Medicine

Dr. Louis Aronne

WeightControl.com:  What is the background for the study “Effect of an Online Weight Management Program Integrated With Population Health Management on Weight Change: A Randomized Clinical Trial”?

Response: More than 70% of U.S. adults have overweight or obesity. Online programs promoting lifestyle change have had some success in helping people achieve and maintain weight loss, but study results have been variable, and these programs have not been widely implemented in primary care. We studied the effectiveness of an online program we have developed (Intellihealth, formerly known as BMIQ) in routine primary care practices, both alone and integrated with population health management (with participants receiving additional support and outreach from nonclinical staff). The study’s objective was to determine whether a combined intervention integrating online weight management with population health management would increase weight loss at 12 months among primary care patients compared with the online program only and usual care.

The study, funded through an award from the Patient-Centered Outcomes Research Institute (PCORI), was carried out as a cluster randomized trial with 840 patients within the Brigham and Women’s Hospital Primary Care Center of Excellence, a group of 15 primary care practices, between 2016 and 2019. Eligible participants had a scheduled primary care visit and were aged 20 to 70 years, had a body mass index between 27 and less than 40, and had a diagnosis of hypertension or type 2 diabetes.

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Study of Childhood Obesity Finds “Patients Are Not Doomed by their Genes”

The readers should take away that lifestyle factors are most important regarding successful weight-loss strategies.

WeightControl.com Interview with:
Melanie Heitkamp, PhD
Department of Prevention and Sports Medicine
Centre for Sports Cardiology, University Hospital
Technical University of Munich
Munich, Germany

WeightControl.com:  What is the background for this study?

Response: There are genetic loci influencing obesity risk in children, which have been identified by large genome-wide association studies. However, the current knowledge about associations between these obesity related genes and obesity treatment success is scarce and the results of previous studies are inconsistent. However, it is an important question as there is a wide inter-individual response to obesity treatment. 

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Weight Loss in Low Income Patients in Primary Care Settings

Clinically significant weight loss is possible in underserved, low-income patients in primary care settings.

WeightControl.com Interview with:
Peter Katzmarzyk, Ph.D., FACSM, FAHA, FTOS
Professor and Marie Edana Corcoran Endowed Chair
Pediatric Obesity and Diabetes
Assoc Exec Dir for Population and Public Health Sciences
Pennington Biomedical Research Center
Baton Rouge, LA

WeightControl.com:  What is the background for this study?

Response: Obesity remains one of the greatest public health threats, and there is good evidence that intensive lifestyle interventions should be a primary approach to obesity management and treatment. However, there has been minimal uptake of obesity treatment approaches in primary care, which is the cornerstone of medicine in the US.

WeightControl.com: What are the main findings?

Response: We developed an intervention to reduce calorie intake and increase physical activity that was delivered by health coaches embedded in primary care clinics. The sample was diverse with a large percentage of low-income and African American patients. The results demonstrated that patients in the intensive lifestyle intervention lost approximately 5% of their initial body weight, compared to patients in usual care who lost about 0.5% of their body weight. These weight loss differences between the two groups were maintained out to 2 years, which demonstrates the durability of the intervention.    

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Same Health Benefits with Fast or Slow Weight Loss

WeightControl.com Interview with:

Jennifer L. Kuk, PhD
Associate Professor
York University
School of Kinesiology and Health Science
Sherman Health Science Research Centre, Rm 2002
Toronto, Ontario 

WeightControl.com:  What is the background for this study?  What are the main findings?

Response: Traditionally, weight loss is prescribed at the rate of 1 to 2 pounds per week.  However, this is largely based on the observation that weight losses faster than 2 pounds per week put patients at an increased risk for gallstones.  It is unclear whether this is the optimal rate of weight loss for CVD or diabetes outcomes. Furthermore, fast weight loss has historically thought to be associated with poorer long term weight loss.  However, this was largely based on research using liquid diets.  Recent evidence suggests that faster weight loss may be similar to slower weight loss when more sensible lifestyle interventions are used.  Thus, if there are additional benefits of faster weight loss for CVD or diabetes outcomes, then there may a rationale for prescribing faster weight loss as the overall rate of gallstones is fairly low.

We observed that those who lose weight faster than 2lb/wk tend to lose more weight overall, but for the same overall weight loss, there is no difference in terms of health benefits with fast or slow weight loss.

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