Five years after launching a pilot study that showed how integrating weight management into primary care can help patients lose weight and improve their health, UCHealth has rolled out the pioneering PATHWEIGH weight management support system to all 66 of its primary care clinics in Colorado and Wyoming.
Think of PATHWEIGH as the polar opposite of a fad diet. The idea is that by voluntarily and discreetly integrating weight-related topics into ongoing conversations between patients and trusted primary care doctors, patients can better manage their weight over the long term. Here are answers to some of the common questions about PATHWEIGH.
What is PATHWEIGH?
PATHWEIGH was developed by researchers at UCHealth and the University of Colorado School of Medicine. It incorporates weight management into UCHealth’s Epic electronic health record to let primary care providers deliver personalized, efficient, and evidence-based care for patients with obesity.
Is PATHWEIGH a weight loss program?
It is not. Rather, PATHWEIGH is an ever-expanding set of tools and trainings to put long-term, patient-tailored weight management into mainstream medical settings, says Dr. Leigh Perreault, who, with Dr. Seth Kramer, founded PATHWEIGH at UCHealth Family Medicine – Westminster.
How does obesity affect your health?
Obesity is associated with more than 200 often-serious health problems. They include type 2 diabetes, sleep apnea, cellulitis, hypertension (high blood pressure), heart disease, liver problems, depression, reproductive issues, osteoarthritis and orthopedic issues that can lead to joint replacement, and more. Obesity is all-too common. Roughly one-third of the U.S. population is struggling with obesity, and that number is expected to climb to nearly half of U.S. residents by 2030.
How well did PATHWEIGH work in the pilot study?
Among the 109 PATHWEIGH patients at UCHealth Family Medicine – Westminster, the average weight loss was 17.4 pounds over 18 months – more than triple the loss of 5.3 pounds among the 338 participants in a control group at UCHealth Internal Medicine – Lowry.
The numbers tell only part of the story. The PATHWEIGH pilot study showed that working on an ongoing basis with a primary care provider, accessing onsite resources such as behavioral health specialists, and harnessing the power of an electronic health record can bring sustained weight loss and the mental and physical health benefits that come with it.
How did patients lose that much weight with PATHWEIGH?
Diet and exercise played a role, but 10% of pilot participants were referred for bariatric surgery, and about 80% were prescribed medication, Perreault says.
Is PATHWEIGH required for people with obesity or those who are overweight?
No, PATHWEIGH is completely voluntary.
How do you get started with PATHWEIGH?
When you arrive at a UCHealth primary care clinic, you’ll see a sign at the check-in desk that says, “Would you like medical assistance with your weight? Please schedule a weight-prioritized visit at the desk.” Doing so lets the UCHealth medical team know that you’d like to talk about weight concerns in a safe space. That helps both patient and provider avoid awkwardness or embarrassment in bringing up weight issues without a mutual understanding in advance.
What can I expect from my first PATHWEIGH visit?
Your provider will review your bloodwork and ask about your history of weight gain and loss. That matters because someone who gains weight after childbirth may respond to different treatments than someone who has been obese since childhood, for example. You’ll be asked how your weight is impacting your quality of life and will be screened for binge eating, depression, anxiety, attention deficit disorder, and weight-related health issues. Finally, you’ll be asked to share what weight you’re targeting. With test data and answers in hand, your provider can help you craft a weight-loss approach that works for you.
How does PATHWEIGH proceed once you’ve started with it?
A specially designed interface in the Epic electronic health record helps drive the conversation during visits and filters what tools and treatment options might be most appropriate for a given patient. Those range from nutrition counseling to weight-loss medications to help with changing habits to bariatric surgery.
How does PATHWEIGH work going forward?
Patients return for weight-prioritized follow-up visits much in the way that someone with chronic disease comes back to the clinic for ongoing care. PATHWEIGH’s effectiveness hinges on its proceeding in a trusting environment over the long term.
“People need the right medicine, the right coaching, and an ongoing relationship with a person who’s going to be their mentor, coach, and someone who can help them deal with speed bumps along the way – because it’s a journey,” Perreault said.