Weight Loss in Underserved Patients — A Cluster-Randomized Trial

Evidence of the effectiveness of obesity treatment in underserved primary care populations is limited. This cluster randomized trial tested a high intensity, lifestyle based program in 18 primary care clinics serving low income patients. Participants were assigned to either an intensive lifestyle intervention (n=452) or usual care (n=351). The intervention included weekly sessions for 6 months, followed by monthly sessions for 18 months, delivered by embedded health coaches. At 24 months, the intensive lifestyle group achieved significantly greater weight loss (4.99%) compared to the usual care group (0.48%), with a mean difference of 4.51 percentage points (P<0.001). The program was effective in an underserved population, with no significant differences in serious adverse events.

Evidence of the effectiveness of obesity treatment in underserved primary care populations is limited. This cluster randomized trial tested a high intensity, lifestyle based program in 18 primary care clinics serving low income patients. Participants were assigned to either an intensive lifestyle intervention (n=452) or usual care (n=351). The intervention included weekly sessions for 6 months, followed by monthly sessions for 18 months, delivered by embedded health coaches. At 24 months, the intensive lifestyle group achieved significantly greater weight loss (4.99%) compared to the usual care group (0.48%), with a mean difference of 4.51 percentage points (P<0.001). The program was effective in an underserved population, with no significant differences in serious adverse events.