PCORI Answers Critical Questions
PCORI funds studies to help patients and those who care for them answer a range of questions about obesity, such as:
Clinician: Several of my patients who have obesity have asked me how they can lose weight. Which are the most effective ways to help them do so and live healthier lives?
Caregiver: I’m about to have my first child and I’ve heard that giving my baby antibiotics in the first two years of her life could increase her chance of becoming overweight later. Does that risk vary depending on how much of these drugs she receives and how often?
Benefits Manager: We’re hearing that weight loss surgery can improve people’s health, which could mean fewer sick days. But which of the several weight loss surgeries is most effective?
Evidence Updates from PCORI-Funded Studies
|Comparing Two Types of Weight Loss Surgery
Bariatric surgery can help people with obesity lose weight and improve problems related to obesity, like diabetes. But surgery can also cause harm, and outcomes may vary across different procedures. A recent PCORI-funded study compared the benefits and harms of the two most common types of bariatric surgery: Roux-en-Y gastric bypass, or gastric bypass, and sleeve gastrectomy, or sleeve surgery. A pair of Evidence Updates is now available that can help clinicians and patients work together to make informed decisions regarding patient care.
Study Results that Support Better-Informed Decisions
|Comparing Ways to Treat People with Obesity in Rural United States
People living in rural areas are more likely to have obesity than those living in cities, and they are also less likely to have access to weight loss programs. This PCORI-funded study compared three ways to treat obesity in rural populations: regular in-person clinic sessions, in-person group sessions, and phone-based group sessions. In a paper published January 2021 in JAMA, the study reported that people in the in-person group sessions averaged greater weight loss after 24 months than the other two groups.
|Comparative Effectiveness of Different Approaches to Weight Loss Management Programs
This PCORI-funded study compared three types of weight loss management programs for people with high blood pressure or type 2 diabetes who also had overweight or obesity. The study compared outcomes of patients in three groups: an online weight management program with meal plans, menus, and a weight tracker; that same program plus support from a health manager; and usual care. As reported in JAMA, the group that used the online weight management program and had access to a health manager, on average, experienced a statistically significant greater weight loss after 12 months compared to the other two groups.
|Key Lifestyle Changes Can Help Patients with Obesity Lose More Weight, Keep It Off Longer, Study Finds
Reporting in the New England Journal of Medicine, the PROPEL Study found that an intensive healthy lifestyle intervention—which included health coaches embedded in primary care practices working with patients to develop healthy habits—resulted in patients losing significantly more weight than those who received usual care from their primary care clinics, and they kept more weight off at two years later. The results show that successful weight loss can be achieved in primary care settings in a highly underserved population who have significant barriers to obtaining health care services.
|Five-Year Outcomes for Common Bariatric Surgeries
The PCORnet® Bariatric Study—which is using data from PCORnet, The National Patient-Centered Clinical Research Network—to study outcomes among patients who undergo common weight-loss surgeries has published several papers in prominent medical journals. The most recent clinical findings, published in JAMA Surgery, are on diabetes remission outcomes among patients who underwent gastric bypass and gastric sleeve surgeries. Another article, also published in JAMA Surgery, details the five-year outcomes of patients who underwent either gastric bypass or adjustable banding, finding that gastric bypass patients were significantly more likely than gastric sleeve patients to end up back in the hospital in the years following surgery.
Obesity Study Spotlights
This study found that children who were overweight achieved healthier weights after their parents received information about behavior change, and after their clinicians got help counseling families.
This researcher discusses the focus of The PCORnet Bariatric Study and the advantages of using PCORnet®, The National Patient-Centered Clinical Research Network, to conduct research. Read more about the study.
This study in the rural Midwest tests conventional delivery of obesity treatment in clinics by primary care physicians against two other approaches in which care is enhanced by obesity counseling specialists and patient support.