Pragmatic Execution of Online Obesity Treatment in Primary Care Found Effective in New Study

Patients with obesity who regularly engaged in online behavioral obesity treatment within a large primary care network lost over twice the weight of those who participated less frequently, according to new research presented at ObesityWeek^® 2021.

A fully-automated online version of lifestyle treatment for obesity has “tremendous potential” to reach more patients at a lower cost when implemented in primary care, but outcomes achieved via pragmatic application have not been studied, according to researchers led by Graham Thomas, PhD, professor of Psychiatry and Human Behavior at Brown University School of Medicine.

In the current study, providers in a large primary care practice referred patients aged 18-75 years with a body mass index (BMI) ≥25kg/m² and Internet access to a fully-automated online obesity treatment program. Researchers provided the program and analyzed the generated data but had no role in patient care.

The online program consisted of weekly educational video lessons, a website for submitting self-monitored data, and automated feedback. Weight loss was assessed using weekly self-reported weight data and analyzed using the intent-to-treat principle. Also, engagement was assessed using frequency of lessons viewed and submission of self-monitored weight, according to the abstract.

A total of 464 provider-referred patients (70% women, 94% White) enrolled in the online program and entered at least 1 weight post-baseline. In a mixed effects model that used all available weight observations, mean weight loss after 12 weeks was 5.1%. In similar analyses with missing values that researchers assumed to be zero after the last available observation, the mean 12-week weight loss was 3.2%.

On average, participants submitted their weight on 7.8 out of 12 weeks and accessed 6.5 out of 12 lessons, according to the abstract. Overall, 37% of participants submitted their weight on all 12 weeks—defined as “high engagement” for the purpose of the study—and 20% accessed all 12 lessons.

Patients with high engagement were estimated to have lost more than twice the weight of those who submitted their weight less frequently (7.2% vs 3.4%). Also, participants who accessed all 12 lessons lost approximately 8% of their initial body weight compared with 4% in those that watched fewer lessons.

“Pragmatic implementation of a fully-automated online behavioral obesity treatment in routine care within a large primary care network produced clinically meaningful weight loss and may be an effective tool for enhancing access to obesity treatment,” concluded researchers in the study abstract.

Reference: Thomas JG, Panza E, Espel-Huynh HM, et al. 12-week weight loss in automated online obesity treatment implemented pragmatically in primary care. Poster (002) presented at: ObesityWeek 2021; held online November 1-5, 2021.