Weight loss program led by advanced practice providers outperforms routine care in MASLD

Key takeaways:

• The program helped MASLD patients achieve an average weight loss of 4.8% vs. 0.4% with routine care.
• More than 75% of program participants achieved weight loss with a mean total body weight loss of 7.3%.

BOSTON — An intensive, advanced practice provider-guided weight loss program helped patients with metabolic dysfunction-associated steatotic liver disease achieve statistically significant weight loss vs. standard of care.

“In 2018, we created the Weight Intervention in Liver Disease, or WILD pathway, to manage patients who suffered from chronic liver disease and obesity with a goal of more than 10% total body weight loss in this population,” Sarah C. Repking, DNP, ACNP-BC, study author and acute care nurse practitioner in the section of hepatology at Rush University Medical Center, told Healio. “We compared our pathway to the standard of care in our department to see if our care was superior, inferior or equivalent.”

According to researchers, the WILD program is overseen by a hepatologist who is board-certified in obesity medicine and directed by three advanced practice providers (APPs), all of whom are certified in obesity medicine. Participants in the program are monitored monthly to gauge progress with nutrition and exercise interventions, behavioral modifications and weight loss medications.

In a retrospective chart review, Repking and colleagues evaluated data from 71 patients with MASLD who participated in the WILD pathway between October 2018 and March 2023 and compared them with 30 patients who received standard of care in the APP hepatology practice from January 2018 to December 2020.

“The WILD pathway had an average weight loss of 4.8% compared to standard of care with a 0.4% average weight loss, which led to a statistically significant difference,” Repking said.

Results also showed that 77.5% of patients in the WILD pathway achieved weight loss with a mean total body weight loss (TBWL) of 7.3%, while 40% of patients in the standard-of-care cohort achieved weight loss with a mean TBWL of 5.2%.

Further, 43.7% of patients in the WILD pathway achieved at least 5% TBWL vs. 16.7% in the standard-of-care group, with 22.5% and 6.6%, respectively, achieving TBWL of 10% or more.

“Patients in the WILD pathway outperformed both standard of care and clinical trials in

sustaining a 10% or greater total body weight loss,” Repking told Healio. “WILD is a successful and sustainable pathway with a positive effect on weight loss in those with metabolic liver disease.”

She added: “Future endeavors include wanting to evaluate the impact of WILD on disease outcomes as well as financial and productivity benefits.”