Methods
A novel weight management program was established in a University-based
primary care practice in 2018. The practice includes a group of 47
primary care providers who were encouraged to refer patients to this
program. Patients age above 18 and BMI more than 30
kg/m2 were referred to the program. This program was
managed by a primary care physician who is board-certified in obesity
medicine. The program was scheduled for one specific day every week and
patients were scheduled for 40 minutes for the initial consultation.
During this initial visit, patients had a detailed history, physical
examination, and body composition assessment with InBody
270® scale and necessary laboratory tests like
Hemoglobin A1c, Basic metabolic panel, Thyroid Stimulating Hormone. At
the end of this visit, the physician provided them with individualized
meal plans, food journal app education, exercise ideas, and strategies
to control cravings. An individualized treatment plan was outlined based
on the four pillars of obesity management namely Nutrition, Physical
activity, Behavioral therapy and Pharmacotherapy. Patients were given a
follow up in 4-8 weeks for a subsequent visit. Follow up visits were
scheduled for 20 minutes. During these follow up visits, patients were
reassessed on a body composition scale and goals were discussed.
Counselling was provided based on the need. The reported comorbidities
included pre-diabetes, diabetes, hypertension, hyperlipidemia,
cardiovascular disease, sleep apnea, osteoarthritis, malignancy,
depression, and polycystic ovarian syndrome. Pharmacotherapy of obesity
included metformin, phentermine, topiramate, bupropion, naltrexone, and
GLP-1 agonists.
Weight loss interventions included motivational interviewing, dietary
and exercise counseling, behavioral training. Treatment was escalated
with pharmacotherapy to treat obesity when appropriate.