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May 08, 2012

Weight Loss Programs in Clinical Settings

Maintaining a healthy weight is one of the best ways that patients can promote good health.

Maintaining a healthy weight is one of the best ways that patients can promote good health. Not only does a healthy weight reduce risk for heart disease and cardiac events, it can also reduce risk for certain types of cancer and improve quality of life. Despite these benefits, effective weight-loss programming that is sustainable and works for everyone is difficult to come by, especially in clinical settings. So while our doctors might advise overweight or obese patients to lose weight, the support for this venture is often lacking.

To address this issue, researchers recently tested the use of a behavioral intervention promoting physical activity and healthy eating in a clinical setting, such as hospitals or doctors’ offices, to help obese patients lose weight. In this two-year study enrolling nearly 500 sedentary, obese adults, half of the patients received standard weight-loss advice from their physician during regular visits, while the other half received ongoing individualized counseling throughout the study period. After following these patients for two years for changes in waist circumference, researchers found that the intervention helped male patients lose a significant amount of weight and keep it off, in comparison with their male counterparts receiving standard care. However, such weight loss was not as noticeable in female patients. While women in the study did lose a significant amount of weight in the first year of the study in comparison with those receiving standard care, this difference was not significant after 2 years.

Although the weight-loss intervention studied was not completely effective in both men and women, these findings are promising. Not only does the study show that weight-loss interventions can be successful in clinical settings, such as hospitals or doctors’ offices, it demonstrates the importance of tailoring weight-loss programs for individual patients. The behavioral intervention studied, which incorporates individualized counseling for patients, was effective in helping male patients lose weight. If tailored more toward women, it might be more effective for female patients. By identifying effective ways to help all obese patients lose weight, doctors can better support patients in their journey to improve heart health.

Questions for You to Consider

  • What did patients in the behavioral intervention group receive counseling on?

  • Patients in the intervention group received private, ongoing counseling from health educators over the two-year study period. During the first year, patients received counseling on increasing physical activity and improving diet and then maintaining these lifestyle changes. During the second year, counseling varied between patients, depending on their ability and success to incorporate these changes into their lives.
  • Why is effective weight-loss support and programming rare in clinical settings?

  • There are a few possible barriers to weight-loss support in clinical settings, such as limited time, staff support and counseling expertise. There is also a lack of effective treatments for sustained weight loss, which limits clinicians’ abilities to implement such programs in their offices.