{"doi":"10.1001/jamanetworkopen.2024.12192","title":"A Primary Care–Based Weight Navigation Program","abstract":"<jats:sec id=\"ab-zoi240433-4\"><jats:title>Importance</jats:title><jats:p>Evidence-based weight management treatments (WMTs) are underused; strategies are needed to increase WMT use and patients' weight loss.</jats:p></jats:sec><jats:sec id=\"ab-zoi240433-5\"><jats:title>Objective</jats:title><jats:p>To evaluate the association of a primary care–based weight navigation program (WNP) with WMT use and weight loss.</jats:p></jats:sec><jats:sec id=\"ab-zoi240433-6\"><jats:title>Design, Setting, and Participants</jats:title><jats:p>This cohort study comprised a retrospective evaluation of a quality improvement program conducted from October 1, 2020, to September 30, 2021. Data analysis was performed from August 2, 2022, to March 7, 2024. Adults with obesity and 1 or more weight-related condition from intervention and control sites in a large academic health system in the Midwestern US were propensity matched on sociodemographic and clinical factors.</jats:p></jats:sec><jats:sec id=\"ab-zoi240433-7\"><jats:title>Exposure</jats:title><jats:p>WNP, in which American Board of Obesity Medicine–certified primary care physicians offered weight-focused visits and guided patients’ selection of preference-sensitive WMTs.</jats:p></jats:sec><jats:sec id=\"ab-zoi240433-8\"><jats:title>Main Outcomes and Measures</jats:title><jats:p>Primary outcomes were feasibility measures, including rates of referral to and engagement in the WNP. Secondary outcomes were mean weight loss, percentage of patients achieving 5% or more and 10% or more weight loss, referral to WMTs, and number of antiobesity medication prescriptions at 12 months.</jats:p></jats:sec><jats:sec id=\"ab-zoi240433-9\"><jats:title>Results</jats:title><jats:p>Of 264 patients, 181 (68.6%) were female and mean (SD) age was 49.5 (13.0) years; there were no significant differences in demographic characteristics between WNP patients (n = 132) and matched controls (n = 132). Of 1159 WNP-eligible patients, 219 (18.9%) were referred to the WNP and 132 (11.4%) completed a visit. In a difference-in-differences analysis, WNP patients lost 4.9 kg more than matched controls (95% CI, 2.11-7.76; <jats:italic>P</jats:italic> &amp;amp;lt; .001), had 4.4% greater weight loss (95% CI, 2.2%-6.4%; <jats:italic>P</jats:italic> &amp;amp;lt; .001), and were more likely to achieve 5% or more weight loss (odds ratio [OR], 2.90; 95% CI, 1.54-5.58); average marginal effects, 21.2%; 95% CI, 8.8%-33.6%) and 10% or more weight loss (OR, 7.19; 95% CI, 2.55-25.9; average marginal effects, 17.4%; 95% CI, 8.7%-26.2%). Patients in the WNP group were referred at higher rates to WMTs, including bariatric surgery (18.9% vs 9.1%; <jats:italic>P</jats:italic> = .02), a low-calorie meal replacement program (16.7% vs 3.8%; <jats:italic>P</jats:italic> &amp;amp;lt; .001), and a Mediterranean-style diet and activity program (10.6% vs 1.5%; <jats:italic>P</jats:italic> = .002). There were no between-group differences in antiobesity medication prescribing.</jats:p></jats:sec><jats:sec id=\"ab-zoi240433-10\"><jats:title>Conclusions and Relevance</jats:title><jats:p>The findings of this cohort study suggest that WNP is feasible and associated with greater WMT use and weight loss than matched controls. The WNP warrants evaluation in a large-scale trial.</jats:p></jats:sec>","journal":"JAMA Network Open","year":2024,"id":636025,"datarank":0.4636563680037475,"base_score":3.091042453358316,"endowment":3.091042453358316,"self_citation_contribution":0.4636563680037475,"citation_network_contribution":0.0,"self_endowment_contribution":0.4636563680037475,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":21,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1064485,"name":"Cassie D. Turner","orcid":"0000-0003-0496-5312","position":1,"is_corresponding":false},{"id":925287,"name":"Amal Othman","orcid":null,"position":2,"is_corresponding":false},{"id":925289,"name":"Lauren Oshman","orcid":null,"position":3,"is_corresponding":false},{"id":925290,"name":"Jonathan Gabison","orcid":null,"position":4,"is_corresponding":false},{"id":1650367,"name":"Patricia K. Arizaca-Dileo","orcid":null,"position":5,"is_corresponding":false},{"id":1650368,"name":"Eric Walford","orcid":null,"position":6,"is_corresponding":false},{"id":887295,"name":"James Henderson","orcid":"0000-0003-3714-4799","position":7,"is_corresponding":false},{"id":1650371,"name":"Deena Beckius","orcid":null,"position":8,"is_corresponding":false},{"id":341900,"name":"Joyce M. Lee","orcid":"0000-0002-8147-5168","position":9,"is_corresponding":false},{"id":982857,"name":"Eli W. Carter","orcid":null,"position":10,"is_corresponding":false},{"id":925288,"name":"Chris Dallas","orcid":null,"position":11,"is_corresponding":false},{"id":1650378,"name":"Kathyrn Herrera-Theut","orcid":null,"position":12,"is_corresponding":false},{"id":832831,"name":"Caroline R. Richardson","orcid":"0000-0002-1945-6046","position":13,"is_corresponding":false},{"id":266351,"name":"Jeffrey T. Kullgren","orcid":"0000-0001-6269-5707","position":14,"is_corresponding":false},{"id":923986,"name":"Gretchen Piatt","orcid":"0000-0001-6641-6330","position":15,"is_corresponding":false},{"id":258642,"name":"Michele Heisler","orcid":"0000-0002-6889-2063","position":16,"is_corresponding":false},{"id":925292,"name":"Andrew Kraftson","orcid":null,"position":17,"is_corresponding":false},{"id":924835,"name":"Dina H. Griauzde","orcid":"0000-0002-2260-0299","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"A Primary Care–Based Weight Navigation Program","abstract":"<jats:sec id=\"ab-zoi240433-4\"><jats:title>Importance</jats:title><jats:p>Evidence-based weight management treatments (WMTs) are underused; strategies are needed to increase WMT use and patients' weight loss.</jats:p></jats:sec><jats:sec id=\"ab-zoi240433-5\"><jats:title>Objective</jats:title><jats:p>To evaluate the association of a primary care–based weight navigation program (WNP) with WMT use and weight loss.</jats:p></jats:sec><jats:sec id=\"ab-zoi240433-6\"><jats:title>Design, Setting, and Participants</jats:title><jats:p>This cohort study comprised a retrospective evaluation of a quality improvement program conducted from October 1, 2020, to September 30, 2021. Data analysis was performed from August 2, 2022, to March 7, 2024. Adults with obesity and 1 or more weight-related condition from intervention and control sites in a large academic health system in the Midwestern US were propensity matched on sociodemographic and clinical factors.</jats:p></jats:sec><jats:sec id=\"ab-zoi240433-7\"><jats:title>Exposure</jats:title><jats:p>WNP, in which American Board of Obesity Medicine–certified primary care physicians offered weight-focused visits and guided patients’ selection of preference-sensitive WMTs.</jats:p></jats:sec><jats:sec id=\"ab-zoi240433-8\"><jats:title>Main Outcomes and Measures</jats:title><jats:p>Primary outcomes were feasibility measures, including rates of referral to and engagement in the WNP. Secondary outcomes were mean weight loss, percentage of patients achieving 5% or more and 10% or more weight loss, referral to WMTs, and number of antiobesity medication prescriptions at 12 months.</jats:p></jats:sec><jats:sec id=\"ab-zoi240433-9\"><jats:title>Results</jats:title><jats:p>Of 264 patients, 181 (68.6%) were female and mean (SD) age was 49.5 (13.0) years; there were no significant differences in demographic characteristics between WNP patients (n = 132) and matched controls (n = 132). Of 1159 WNP-eligible patients, 219 (18.9%) were referred to the WNP and 132 (11.4%) completed a visit. In a difference-in-differences analysis, WNP patients lost 4.9 kg more than matched controls (95% CI, 2.11-7.76; <jats:italic>P</jats:italic> &amp;amp;lt; .001), had 4.4% greater weight loss (95% CI, 2.2%-6.4%; <jats:italic>P</jats:italic> &amp;amp;lt; .001), and were more likely to achieve 5% or more weight loss (odds ratio [OR], 2.90; 95% CI, 1.54-5.58); average marginal effects, 21.2%; 95% CI, 8.8%-33.6%) and 10% or more weight loss (OR, 7.19; 95% CI, 2.55-25.9; average marginal effects, 17.4%; 95% CI, 8.7%-26.2%). Patients in the WNP group were referred at higher rates to WMTs, including bariatric surgery (18.9% vs 9.1%; <jats:italic>P</jats:italic> = .02), a low-calorie meal replacement program (16.7% vs 3.8%; <jats:italic>P</jats:italic> &amp;amp;lt; .001), and a Mediterranean-style diet and activity program (10.6% vs 1.5%; <jats:italic>P</jats:italic> = .002). There were no between-group differences in antiobesity medication prescribing.</jats:p></jats:sec><jats:sec id=\"ab-zoi240433-10\"><jats:title>Conclusions and Relevance</jats:title><jats:p>The findings of this cohort study suggest that WNP is feasible and associated with greater WMT use and weight loss than matched controls. The WNP warrants evaluation in a large-scale trial.</jats:p></jats:sec>","is_dataset_classified":null,"base_score":3.044522437723423,"endowment":3.044522437723423,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"38771575","pmcid":"PMC11109771","openalex_id":"https://openalex.org/W4398175711","authors":[],"funders":[{"funder_name":"NIDDK NIH HHS","grant_id":"K23 DK123416","title":null},{"funder_name":"NIDDK NIH HHS","grant_id":"P30 DK020572","title":null},{"funder_name":"NIDDK NIH HHS","grant_id":"P30 DK092926","title":null},{"funder_name":"NIDDK NIH HHS","grant_id":"P30 DK089503","title":null},{"funder_name":"National Institutes of Health","grant_id":"5P30DK020572-37","title":"ADMINISTRATIVE CORE"},{"funder_name":"National Institutes of Health","grant_id":"5P30DK089503-04","title":"Administrative Core"},{"funder_name":"National Institutes of Health","grant_id":"3P30DK092926-06S1","title":"Michigan Center for Diabetes Translational Research"},{"funder_name":"National Institutes of Health","grant_id":"5K23DK123416-05","title":"A multilevel intervention to support weight loss among individuals with prediabetes in primary care settings"}],"total_grants":8,"fwci":15.6117,"citation_percentile":0.99417664,"influential_citations":0,"citation_trend":[{"year":2025,"count":11},{"year":2026,"count":9}],"oa_status":"gold","license":"cc-by","oa_locations":[{"url":"https://jamanetwork.com/journals/jamanetworkopen/articlepdf/2818868/griauzde_2024_oi_240433_1715284906.04182.pdf","host_type":"journal"},{"url":"https://jamanetwork.com/journals/jamanetworkopen/articlepdf/2818868/griauzde_2024_oi_240433_1715284906.04182.pdf","host_type":"publisher"},{"url":"https://doi.org/10.1001/jamanetworkopen.2024.12192","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/38771575","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/11109771","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC11109771","host_type":"Europe_PMC"},{"url":"http://dx.doi.org/10.1001/jamanetworkopen.2024.12192","host_type":""}],"fields_of_study":["Obesity and Health Practices","Bariatric Surgery and Outcomes","Obesity, Physical Activity, Diet","03 medical and health sciences","0302 clinical medicine","Humans","Female","Male","Primary Health Care","Retrospective Studies","Middle Aged","Adult","Obesity","Weight Loss","Weight Reduction Programs","Patient Navigation","Quality Improvement","Cohort Studies"],"mesh_terms":["Adult","Female","Humans","Male","Middle Aged","Obesity","Primary Health Care","Retrospective Studies","Cohort Studies","Weight Loss","Quality Improvement","Weight Reduction Programs","Patient Navigation"],"keywords":["Primary care","Computer science","Medicine","Family medicine","Male","Adult","Primary Health Care","Middle Aged","Quality Improvement","Weight Reduction Programs","Cohort Studies","Weight Loss","Humans","Patient Navigation","Female","Obesity","Original Investigation","Retrospective Studies"],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-06T16:01:20.577963Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}