New Intervention Shows Promise in Curbing Weight Gain, Even Without Direct Patient Care
A novel healthcare intervention, dubbed PATHWEIGH, demonstrated a significant ability to mitigate weight gain in adults, even among those who didn’t receive direct weight-related care, according to a study analyzing data from over 574,000 patients. The findings, stemming from a four-year study conducted between March 2020 and March 2024 across 56 clinics, suggest a systemic approach to weight management can yield positive results at a population level.
A Large-Scale Look at Weight Trajectories
Researchers examined the weight trajectories of 574,004 adult patients, focusing on 274,182 individuals with a body mass index (BMI) of 25 kg/m² or higher who had at least two weight measurements recorded. The study compared outcomes for patients receiving “usual care” versus those participating in the PATHWEIGH intervention. The intervention itself comprised three key components: leadership endorsement from the health system, an electronic health record (EHR)-driven care process to prioritize weight management, and implementation strategies to support clinicians.
Intervention Reduces Weight Gain, Even Without Direct Care
The analysis revealed a stark contrast in weight trends. Patients in the usual care group experienced an average weight gain of 0.47 kg over the study period, while those in the intervention group experienced a slight weight loss of 0.10 kg. A counterfactual analysis indicated that the intervention decreased average weight by 0.58 kg compared to usual care, effectively eliminating the population-level weight gain typically observed. Notably, even among the 138,745 patients who never received discernable weight-related care, the intervention mitigated weight gain by 0.32 kg over 18 months.
Impact of Direct Weight Management
The benefits of PATHWEIGH were even more pronounced for patients who did receive weight-related care. Those receiving care during the intervention phase experienced a total weight loss of 2.18 kg over 18 months, a substantial 1.73 kg improvement compared to those receiving care during usual care. “These findings underscore the importance of both systemic changes and direct patient intervention in addressing the obesity epidemic,” stated a senior official involved in the study.
How Care Was Delivered & Clinic Engagement
Trackable weight-related care included referrals to weight loss clinics, bariatric surgery, and the use of anti-obesity medications. Interestingly, the study found a decrease in referrals to weight loss clinics and bariatric surgery during the intervention phase, but a significant increase in the reporting of anti-obesity medication use. This suggests a shift in the types of interventions being utilized.
Clinic engagement with the PATHWEIGH implementation strategies varied. Approximately 64% of clinics showed moderate engagement, while 21% demonstrated a higher level of involvement and 14% engaged to a lesser degree. .
Safety Profile Remains Strong
The intervention demonstrated a favorable safety profile, with no health metric changing by more than 1% in an unfavorable direction. While death rates were slightly higher in the intervention group (1.7% versus 0.6% in usual care), researchers attributed this to an enrichment of older patients in the intervention cohort. The timing of the study, overlapping with the COVID-19 pandemic, also influenced mortality rates, with COVID-related deaths becoming less common as the intervention was rolled out.
These findings offer a promising pathway for addressing weight management at a population level, highlighting the potential of systemic interventions to improve public health outcomes.
