Population management, online program helps patients lose weight, study finds

Researchers from Brigham and Women's Hospital paired an online weight loss program with a phone- and email-based population health management program, and determined that patients in the combined program had greater weight loss over 12 months than patients in the other two groups, according to new findings published in JAMA.

More than 70 percent of U.S. adults have overweight or obesity. While primary care physicians (PCPs) are often the most immediate source of counseling for those trying to lose weight, most PCPs do not have the time, training, or support to guide their patients through a comprehensive weight loss program. Additionally, studies of online weight loss programs have found mixed levels of success.

Population health management programs, which are delivered by non-clinical staff members, have emerged as supplemental support systems that offer outreach for preventive and chronic condition care needs, outside of primary care visits, the researchers said.

The study followed 840 patients in the Brigham's Primary Care Center of Excellence, a network of 15 practices, between 2016 and 2019. Participants, all of whom either had overweight or obesity and hypertension or type 2 diabetes, were divided into three study groups. The "usual care" group received general information about weight management in the mail; the "online only" group participated in an online weight-loss program, which included meal plans, activity trackers, and progress reporting features; and the "combined intervention" group participated in the online program while receiving additional outreach and support from non-clinical staff members monitoring their progress, according to the study.

Over the course of 12 months, the usual care, online only, and combined intervention groups lost an average of 2.7 pounds, 4.1 pounds, and 6.9 pounds, respectively. The researchers found that the combined intervention produced a small but statistically significant increase in weight loss compared to the other two methods. Moreover, participants in the combined intervention group decreased their body weight by an average of 3 percent, a statistically significant difference from the 1.4 and 1.9 percent decreases found in the usual care and online only groups, the researchers said.

The researchers said they acknowledge that while the amount of weight loss is low, clinically significant health benefits are associated with a 3 to 5 percent decrease in weight among individuals with overweight or obesity. Approximately one third of participants in the combined intervention group lost 5 percent or more of their weight, compared to only 14.9 and 20.8 percent of participants in the usual care and online only groups, respectively. In addition, the researchers said the weight loss in the combined intervention group was also maintained at 18 months, although active interventions ceased after 12 months.