Implementation of a primary care physician network obesity management program

Most primary care physicians do not treat obesity, citing lack of time, res ources, insurance reimbursement, and knowledge of effective interventions a s significant barriers. To address this need, a 10-minute intervention deli vered by the primary care physician was coupled with individual dietary cou nseling sessions delivered by a registered dietitian via telephone with an automated calling system (House-Calls, Mobile, AL). Patients were seen for follow-up by their physician at weeks 4, 12, 24, 36 and 52. A total of 252 patients (202 women and 50 men) were referred by 18 primary care physicians to the program. The comorbid conditions reported for all patients at basel ine included low back pain, 29% (n = 72); hypertension, 45% (n = 113); hype rcholesterolemia, 41% (n = 104); type 2 diabetes, 10% (n = 26); and sleep a pnea, 5% (n = 12). When offered a choice of meal plans based on foods or me al replacements, two-thirds of patients (n = 166) chose to use meal replace ments (Ultra Slim-Fast; Slim-Fast Foods Co., West Palm Beach, FL) at least once daily. Baseline weights of subjects averaged 200 +/- 46 lb for women ( n = 202) and 237 +/- 45 lb for men (n = 50). Patients completing 6 months i n the program lost an average of 19.0 +/- 4.0 lb for women (n = 94) and 15. 5 +/- 8.2 lb for men (n = 26). Physicians reported a high degree of satisfa ction with the program, suggesting that a brief, effective physician-direct ed program with nutritionist support by telephone can be implemented in a b usy primary care office.