Pragmatic implementation of a fully automated online obesity treatment in primary care. Issue 8 (27th July 2022)

• Record Type: Journal Article
• Authors: Thomas, J. Graham; Panza, Emily; Espel‐Huynh, Hallie M.; Goldstein, Carly M.; O'Leary, Kevin; Benedict, Noah; Puerini, Albert J.; Wing, Rena R.
• Is Part Of: Obesity. Volume 30:Issue 8(2022)
• Page Start: 1621
• Page End: 1628
• Publication Date: 2022-07-27
• Subjects: Obesity -- Periodicals; 616.398005
• DOI: 10.1002/oby.23502
• Languages: English
• ISSNs: 1930-7381

Abstract

Abstract: Objective: Behavioral obesity treatment implemented in primary care is efficacious but typically involves face‐to‐face or phone contact. This study evaluated enrollment, engagement, and 12‐week weight loss in a fully automated online behavioral weight‐loss intervention implemented pragmatically in a primary care network. Methods: As part of routine primary care, providers and nurse care managers offered a no‐cost online obesity treatment program to 1, 721 patients. Of these, 721 consented and were eligible (aged 18‐75 years with BMI ≥ 25 kg/m 2 and internet access), and 464 started the program. The program included 12 weekly online lessons, a self‐monitoring platform, and automated feedback. Results: More than one‐quarter of patients who were offered the program (26%) initiated treatment. In intent‐to‐treat analyses using all data available, mean 12‐week weight change was −5.10% (SE = 0.21). Patients who submitted their weights on all 12 weeks (37% of 464) lost an estimated 7.2% body weight versus 3.4% in those submitting less frequently. Conclusions: This fully automated online program, implemented into the routine workflow of a primary care setting without any human counseling or researcher involvement, produced clinically meaningful short‐term weight loss. Greater program engagement was associated with greater weight loss; efforts are needed to understand barriers to engagement.