STUDY SAYS DOCTORS
may make weight loss difference
Can physicians make a difference when it comes to successful weight loss outcomes? A new study supports the idea that the right health care provider just might.
According to an article in Medical News Today, a recent study conducted by researchers from Johns Hopkins University and published in Patient Education and Counseling found that “obese people participating in a weight loss clinical trial who reported their health care provider’s support as particularly helpful lost twice as much weight as those who did not.”
The Johns Hopkins study was based on analysis of data taken from the Practice-based Opportunities for Weight Reduction (POWER) trial – a government-funded, randomized controlled study that ran for two years.
Below, Wendy Bennett, MD, MPH of Johns Hopkins and the study’s lead author, answers additional questions about the study and what it might mean for obesity medicine certification:
Why should this study encourage physicians to talk about obesity?
First, it doesn’t hurt and could only help. Patients in the POWER weight loss study had very high quality relationships with their providers. Patients who lost more weight stated that they were more satisfied with the helpfulness of their providers in the study – i.e. being involved with the program, referring them into the program and reviewing their progress reports at the time of their visits. Second, although the coaches did most of the weight loss counseling, patients felt like the program was linked with their primary care practices and that their providers were receiving updates, which may have helped with their weight loss.
Does this study make a case for physicians to learn more about how to treat obesity from a medical standpoint?
In our trial, the coaches did the weight loss counseling and providers had a limited role. In a qualitative focus group study we did with the providers who had patients in the POWER study, the majority of these engaged providers preferred to be on the sidelines, referring and reviewing their patients’ progress and cheerleading and providing support, but did not feel equipped or have sufficient time to do the weight management counseling themselves.
What are the best skills/knowledge that a physician should acquire to have a positive impact on patients needing to lose weight?
Study participants rated their providers very highly for patient-provider relationship (high levels of trust, communication and feeling known as a person) which might facilitate weight loss. In our study, because the providers were so highly rated we could not discern a difference in weight loss by patient-provider relationship quality. However, our results highlight that patients highly value their providers and their providers’ involvement in their weight loss efforts.
What practical ways might we consider to better incorporate physicians into weight loss programs and initiatives?
Following the findings of this study we have continued to develop strategies to involve providers in weight management. Some things we are working on include: enabling providers to refer patients into programs (i.e. paper and electronic referrals), providing lists of evidence-based programs in the surrounding community, and connecting providers with programs so they can receive weight loss program reports to review with their patients. In addition, we are working with health coaches to remind participants to discuss health concerns with their providers, and for those losing weight to check-in about whether diabetes or blood pressure medications need adjustments.
Are there any structural or policy recommendations that this study/outcome suggests may be helpful?
Our study shows the need for reimbursement models to support multidisciplinary programs that would reimburse health coaches and behavioral psychologists, as well as physicians. There is also a need to test other primary care based weight management programs where these multidisciplinary providers, such as health coaches, work side by side or remotely with a care team, especially for high risk and diverse populations, where a medical home model could enhance adherence, sustained weight loss and chronic disease prevention.