Making an Intensive Behavioral Treatment for Patients with Obesity Part of Regular Care at Primary Care Clinics

PCORI implementation projects promote the use of findings from PCORI-funded studies in real-world healthcare and other settings. These projects build toward broad use of evidence to inform healthcare decisions.

This PCORI-funded implementation project is making intensive behavioral treatment to help people with obesity lose weight and maintain weight loss part of regular care in primary care clinics.

More than 40% of adults in the United States have obesity. Obesity can lead to serious health problems such as diabetes and heart disease. Intensive behavioral treatment, or IBT, is a treatment option that can help people with obesity manage their weight. But primary care doctors may have limited time to provide weight loss support during clinic visits, particularly in clinics with limited staffing.

What is the goal of this implementation project?

IBT can help people with obesity manage their weight by changing their diet and exercise habits. Two PCORI-funded studies looked at approaches for delivering IBT in primary care, with a focus on care for patients from under-resourced communities. One study found that patients receiving IBT delivered by health coaches lost more weight after two years than patients receiving usual care. The second study found that patients having group visits at clinics lost more weight after two years than patients having remote group visits or one-on-one visits at the clinics.

This project will draw on findings from these studies to make IBT for weight loss part of regular care at primary care clinics across the United States.

What will this project do?

The project team is putting IBT in place at 30 primary care clinics in 11 states, including those serving communities that are rural, low income, and under-resourced.

Clinics can use one of three approaches:

• Group visits led by a clinician, such as a doctor or nurse practitioner, or by another member of the clinical team such as a nurse or dietician
• One-on-one visits with a clinician who acts as the health coach
• One-on-one visits with another member of the clinical team who acts as the health coach

The project team is working with clinics to select the approach that works best for them and the patients they serve.

A champion at each clinic will lead the effort to make IBT part of regular care. The project team is training clinicians and clinic staff on how to deliver IBT. They are also providing clinics with ongoing support through:

• Monthly coaching calls with sites led by practice facilitators and coaches who are experienced weight management clinicians
• Regular monitoring of clinics’ use of IBT and patient health outcomes
• Learning community meetings to support practice champions and other clinic staff in addressing common problems in using the IBT model they are putting in place

What is the expected impact of this project?

The project will demonstrate approaches that work for primary clinics to deliver IBT. About 2,300 patients with obesity will receive IBT. The project evaluation will confirm that the IBT approaches are working as intended to help people with obesity lose weight.

The project team will update training materials and resources based on what this project learns. The team will make these materials available for other clinics to use in the future.

More about this implementation project: