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Abstract:

Background: Primary care providers may refer their patients to a variety of weight loss programs and diet plans. However, the relative effectiveness of the available options is not well understood. This retrospective study compared weight loss in an intensive structured (IS) program using health educators versus weight loss in the general population of primary care patients seeking to lose weight using less intensive (LI) methods.

Methods: The IS program in this study is operated by Luther Midelfort Weight Management Services in Eau Claire, WI, USA, which is a part of the Mayo Health System. All consecutive patients enrolled in the IS program who met inclusion criteria were included in the sample. The LI group was a convenience sample of patients drawn from other Mayo Clinic locations who were surveyed to determine what, if any, approach to weight loss they were using. Weight loss strategies reported by potential LI participants included LA Weight Loss, Nutri-System^®, SlimFast, Weight Watchers^®, `own approach,' and other. Those who were not using a weight loss approach were excluded. The selection criteria for the study were that patients had a body mass index (BMI) of 35-50 kg/m² and were aged 17-65 years. Weights were measured in clinic. The baseline year was 2005 and the follow-up year was 2006.

Results: A total of 126 patients met the selection criteria: 71 in the IS group and 55 in the LI group. Outcome weights were available for 103 patients: 58 and 45 in the IS and LI groups, respectively. The mean weight changes were −18.8 (±15.7) kg and 0.87 (±5.9) kg for the IS and LI groups, respectively (p < 0.001). These results were confirmed using ordinary least squares regression analysis.

Conclusion: IS weight loss programs staffed by health educators may be effective for selected patients. Despite its limitations, this small study encourages further investigations into the effectiveness of high-intensity weight loss programs in patient populations of different race, ethnicity, socioeconomic status, and genetic background, after appropriate adjustments to assure cultural sensitivity. Further refinement and testing of moderate intensity programs is also warranted.

Keywords: Disease management programme evaluation; Health education; Obesity

Document Type: Research article

Affiliations: 1: 1 Department of Family Medicine, Mayo Clinic, Rochester, Minnesotta, USA 2: 2 Mayo Clinic - Jacksonville, Jacksonville, Florida, USA 3: 3 Mayo Health System Midelfort Clinic, Eau Claire, Wisconsin, USA

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Effectiveness of a Structured Intensive Weight Loss Program Using Health Educators