Weight management programs should include at least 12 interactions

At least 12 in-person or virtual interactions are needed to deliver effective weight management interventions in primary care, according to findings published in BMJ.

“As about 39% of the world’s population is living with obesity, helping people to manage their weight is an enormous task,” Claire D. Madigan, PhD, a senior research associate at the Centre for Lifestyle Medicine and Behavior at Loughborough University in the United Kingdom, and colleagues wrote. “Primary care offers good reach into the community as the first point of contact in the health care system and the remit to provide whole person care across the life course.”

Madigan and colleagues conducted a systematic review and meta-analysis of 34 randomized clinical trials evaluating behavioral weight management interventions in primary care. The trials included about 8,000 adults with a BMI greater than or equal to 25 kg/m². The researchers evaluated weight and waist circumference changes after at least 12 months of interventive management. Their outcomes were compared with individuals in control groups, in which participants either received no or minimal intervention.

On average, participants in the intervention groups had 2.3 kg greater weight loss than participants in the control groups at 12 months (P < .001), according to Madigan and colleagues. In the trials that continued for 24 or more months, the intervention groups had 1.8 kg greater weight loss than control groups (P < .001).

Among trials that reported waist circumference, the intervention groups had a 2.5 cm greater reduction compared with the control groups (P < .001).

The researchers found that a greater number of contacts between patients and clinicians led to more pronounced weight loss. In addition, interventions provided by both physicians and nonmedical practitioners showed similarly statistically significant weight loss among patients, according to Madigan and colleagues.

Overall, the findings indicate that behavioral weight loss interventions for adults with obesity can be delivered effectively in primary care.

“Previous evidence suggests that general practitioners find it difficult to raise the issue of weight with patients and are pessimistic about the success of weight loss interventions,” Madigan and colleagues wrote. “Therefore, interventions should be implemented with appropriate training for primary care practitioners so that they feel confident about helping patients to manage their weight.”