Weight Loss in Underserved Patients — A Cluster-Randomized Trial
In this cluster-randomized trial, carried out in an underserved population, the authors hypothesized that a high-intensity lifestyle intervention would result in greater weight loss than usual care. Patients assigned to the high-intensity program lost significantly more weight than patients who rece...
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| Published in: | The New England journal of medicine Vol. 383; no. 10; pp. 909 - 918 |
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| Main Authors: | , , , , , , , , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
United States
Massachusetts Medical Society
03.09.2020
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| Subjects: | |
| ISSN: | 0028-4793, 1533-4406, 1533-4406 |
| Online Access: | Get full text |
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| Abstract | In this cluster-randomized trial, carried out in an underserved population, the authors hypothesized that a high-intensity lifestyle intervention would result in greater weight loss than usual care. Patients assigned to the high-intensity program lost significantly more weight than patients who received usual care. |
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| AbstractList | BackgroundEvidence of the effectiveness of treatment for obesity delivered in primary care settings in underserved populations is lacking.MethodsWe conducted a cluster-randomized trial to test the effectiveness of a high-intensity, lifestyle-based program for obesity treatment delivered in primary care clinics in which a high percentage of the patients were from low-income populations. We randomly assigned 18 clinics to provide patients with either an intensive lifestyle intervention, which focused on reduced caloric intake and increased physical activity, or usual care. Patients in the intensive-lifestyle group participated in a high-intensity program delivered by health coaches embedded in the clinics. The program consisted of weekly sessions for the first 6 months, followed by monthly sessions for the remaining 18 months. Patients in the usual-care group received standard care from their primary care team. The primary outcome was the percent change from baseline in body weight at 24 months.ResultsAll 18 clinics (9 assigned to the intensive program and 9 assigned to usual care) completed 24 months of participation; a median of 40.5 patients were enrolled at each clinic. A total of 803 adults with obesity were enrolled: 452 were assigned to the intensive-lifestyle group, and 351 were assigned to the usual-care group; 67.2% of the patients were Black, and 65.5% had an annual household income of less than $40,000. Of the enrolled patients, 83.4% completed the 24-month trial. The percent weight loss at 24 months was significantly greater in the intensive-lifestyle group (change in body weight, −4.99%; 95% confidence interval [CI], −6.02 to −3.96) than in the usual-care group (−0.48%; 95% CI, −1.57 to 0.61), with a mean between-group difference of −4.51 percentage points (95% CI, −5.93 to −3.10) (P<0.001). There were no significant between-group differences in serious adverse events.ConclusionsA high-intensity, lifestyle-based treatment program for obesity delivered in an underserved primary care population resulted in clinically significant weight loss at 24 months. (Funded by the Patient-Centered Outcomes Research Institute and others; PROPEL ClinicalTrials.gov number, NCT02561221.) In this cluster-randomized trial, carried out in an underserved population, the authors hypothesized that a high-intensity lifestyle intervention would result in greater weight loss than usual care. Patients assigned to the high-intensity program lost significantly more weight than patients who received usual care. Evidence of the effectiveness of treatment for obesity delivered in primary care settings in underserved populations is lacking.BACKGROUNDEvidence of the effectiveness of treatment for obesity delivered in primary care settings in underserved populations is lacking.We conducted a cluster-randomized trial to test the effectiveness of a high-intensity, lifestyle-based program for obesity treatment delivered in primary care clinics in which a high percentage of the patients were from low-income populations. We randomly assigned 18 clinics to provide patients with either an intensive lifestyle intervention, which focused on reduced caloric intake and increased physical activity, or usual care. Patients in the intensive-lifestyle group participated in a high-intensity program delivered by health coaches embedded in the clinics. The program consisted of weekly sessions for the first 6 months, followed by monthly sessions for the remaining 18 months. Patients in the usual-care group received standard care from their primary care team. The primary outcome was the percent change from baseline in body weight at 24 months.METHODSWe conducted a cluster-randomized trial to test the effectiveness of a high-intensity, lifestyle-based program for obesity treatment delivered in primary care clinics in which a high percentage of the patients were from low-income populations. We randomly assigned 18 clinics to provide patients with either an intensive lifestyle intervention, which focused on reduced caloric intake and increased physical activity, or usual care. Patients in the intensive-lifestyle group participated in a high-intensity program delivered by health coaches embedded in the clinics. The program consisted of weekly sessions for the first 6 months, followed by monthly sessions for the remaining 18 months. Patients in the usual-care group received standard care from their primary care team. The primary outcome was the percent change from baseline in body weight at 24 months.All 18 clinics (9 assigned to the intensive program and 9 assigned to usual care) completed 24 months of participation; a median of 40.5 patients were enrolled at each clinic. A total of 803 adults with obesity were enrolled: 452 were assigned to the intensive-lifestyle group, and 351 were assigned to the usual-care group; 67.2% of the patients were Black, and 65.5% had an annual household income of less than $40,000. Of the enrolled patients, 83.4% completed the 24-month trial. The percent weight loss at 24 months was significantly greater in the intensive-lifestyle group (change in body weight, -4.99%; 95% confidence interval [CI], -6.02 to -3.96) than in the usual-care group (-0.48%; 95% CI, -1.57 to 0.61), with a mean between-group difference of -4.51 percentage points (95% CI, -5.93 to -3.10) (P<0.001). There were no significant between-group differences in serious adverse events.RESULTSAll 18 clinics (9 assigned to the intensive program and 9 assigned to usual care) completed 24 months of participation; a median of 40.5 patients were enrolled at each clinic. A total of 803 adults with obesity were enrolled: 452 were assigned to the intensive-lifestyle group, and 351 were assigned to the usual-care group; 67.2% of the patients were Black, and 65.5% had an annual household income of less than $40,000. Of the enrolled patients, 83.4% completed the 24-month trial. The percent weight loss at 24 months was significantly greater in the intensive-lifestyle group (change in body weight, -4.99%; 95% confidence interval [CI], -6.02 to -3.96) than in the usual-care group (-0.48%; 95% CI, -1.57 to 0.61), with a mean between-group difference of -4.51 percentage points (95% CI, -5.93 to -3.10) (P<0.001). There were no significant between-group differences in serious adverse events.A high-intensity, lifestyle-based treatment program for obesity delivered in an underserved primary care population resulted in clinically significant weight loss at 24 months. (Funded by the Patient-Centered Outcomes Research Institute and others; PROPEL ClinicalTrials.gov number, NCT02561221.).CONCLUSIONSA high-intensity, lifestyle-based treatment program for obesity delivered in an underserved primary care population resulted in clinically significant weight loss at 24 months. (Funded by the Patient-Centered Outcomes Research Institute and others; PROPEL ClinicalTrials.gov number, NCT02561221.). Evidence of the effectiveness of treatment for obesity delivered in primary care settings in underserved populations is lacking. We conducted a cluster-randomized trial to test the effectiveness of a high-intensity, lifestyle-based program for obesity treatment delivered in primary care clinics in which a high percentage of the patients were from low-income populations. We randomly assigned 18 clinics to provide patients with either an intensive lifestyle intervention, which focused on reduced caloric intake and increased physical activity, or usual care. Patients in the intensive-lifestyle group participated in a high-intensity program delivered by health coaches embedded in the clinics. The program consisted of weekly sessions for the first 6 months, followed by monthly sessions for the remaining 18 months. Patients in the usual-care group received standard care from their primary care team. The primary outcome was the percent change from baseline in body weight at 24 months. All 18 clinics (9 assigned to the intensive program and 9 assigned to usual care) completed 24 months of participation; a median of 40.5 patients were enrolled at each clinic. A total of 803 adults with obesity were enrolled: 452 were assigned to the intensive-lifestyle group, and 351 were assigned to the usual-care group; 67.2% of the patients were Black, and 65.5% had an annual household income of less than $40,000. Of the enrolled patients, 83.4% completed the 24-month trial. The percent weight loss at 24 months was significantly greater in the intensive-lifestyle group (change in body weight, -4.99%; 95% confidence interval [CI], -6.02 to -3.96) than in the usual-care group (-0.48%; 95% CI, -1.57 to 0.61), with a mean between-group difference of -4.51 percentage points (95% CI, -5.93 to -3.10) (P<0.001). There were no significant between-group differences in serious adverse events. A high-intensity, lifestyle-based treatment program for obesity delivered in an underserved primary care population resulted in clinically significant weight loss at 24 months. (Funded by the Patient-Centered Outcomes Research Institute and others; PROPEL ClinicalTrials.gov number, NCT02561221.). |
| Author | Springgate, Benjamin Thethi, Tina K Lavie, Carl J Price-Haywood, Eboni G Denstel, Kara D Brantley, Phillip J Fonseca, Vivian Sarpong, Daniel F Davis, Terry C Johnson, William D Kennedy, Kathleen B Newton, Robert L Katzmarzyk, Peter T Arnold, Connie L Apolzan, John W Gugel, Jonathan Mire, Emily F Martin, Corby K |
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Geriatrics (J.G.), Tulane University Health Sciences Center School of Medicine, Southeast Louisiana Veterans Health Care System (T.K.T., V.F.), the College of Pharmacy, Xavier University of Louisiana (K.B.K., D.F.S.), and the Department of Internal Medicine, Louisiana State University School of Medicine, and Program in Health Policy and Systems Management, Louisiana State University School of Public Health (B.S.), New Orleans — all in Louisiana – sequence: 11 givenname: Phillip J surname: Brantley fullname: Brantley, Phillip J organization: From the Pennington Biomedical Research Center, Baton Rouge (P.T.K., C.K.M., R.L.N., J.W.A., K.D.D., E.F.M., P.J.B., W.D.J.), the Department of Medicine and Feist–Weiller Cancer Center, Louisiana State University Health Sciences Center, Shreveport (C.L.A., T.C.D.), and Ochsner Clinic Foundation, Center for Outcomes and Health Services Research (E.G.P.-H.) and Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute (C.J.L.), 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Tulane University Health Sciences Center School of Medicine, Southeast Louisiana Veterans Health Care System (T.K.T., V.F.), the College of Pharmacy, Xavier University of Louisiana (K.B.K., D.F.S.), and the Department of Internal Medicine, Louisiana State University School of Medicine, and Program in Health Policy and Systems Management, Louisiana State University School of Public Health (B.S.), New Orleans — all in Louisiana – sequence: 15 givenname: Kathleen B surname: Kennedy fullname: Kennedy, Kathleen B organization: From the Pennington Biomedical Research Center, Baton Rouge (P.T.K., C.K.M., R.L.N., J.W.A., K.D.D., E.F.M., P.J.B., W.D.J.), the Department of Medicine and Feist–Weiller Cancer Center, Louisiana State University Health Sciences Center, Shreveport (C.L.A., T.C.D.), and Ochsner Clinic Foundation, Center for Outcomes and Health Services Research (E.G.P.-H.) and Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute (C.J.L.), Ochsner Clinical 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Shreveport (C.L.A., T.C.D.), and Ochsner Clinic Foundation, Center for Outcomes and Health Services Research (E.G.P.-H.) and Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute (C.J.L.), Ochsner Clinical School–University of Queensland School of Medicine (E.G.P.-H., C.J.L.), the Department of Medicine, Division of Endocrinology and Metabolism (T.K.T., V.F.) and the Department of Medicine, Section of General Internal Medicine and Geriatrics (J.G.), Tulane University Health Sciences Center School of Medicine, Southeast Louisiana Veterans Health Care System (T.K.T., V.F.), the College of Pharmacy, Xavier University of Louisiana (K.B.K., D.F.S.), and the Department of Internal Medicine, Louisiana State University School of Medicine, and Program in Health Policy and Systems Management, Louisiana State University School of Public Health (B.S.), New Orleans — all in Louisiana – sequence: 17 givenname: Daniel F surname: Sarpong fullname: Sarpong, Daniel F organization: From the Pennington Biomedical Research Center, Baton Rouge (P.T.K., C.K.M., R.L.N., J.W.A., K.D.D., E.F.M., P.J.B., W.D.J.), the Department of Medicine and Feist–Weiller Cancer Center, Louisiana State University Health Sciences Center, Shreveport (C.L.A., T.C.D.), and Ochsner Clinic Foundation, Center for Outcomes and Health Services Research (E.G.P.-H.) and Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute (C.J.L.), Ochsner Clinical School–University of Queensland School of Medicine (E.G.P.-H., C.J.L.), the Department of Medicine, Division of Endocrinology and Metabolism (T.K.T., V.F.) and the Department of Medicine, Section of General Internal Medicine and Geriatrics (J.G.), Tulane University Health Sciences Center School of Medicine, Southeast Louisiana Veterans Health Care System (T.K.T., V.F.), the College of Pharmacy, Xavier University of Louisiana (K.B.K., D.F.S.), and the Department of Internal Medicine, Louisiana State University School of Medicine, and Program in Health Policy and Systems Management, Louisiana State University School of Public Health (B.S.), New Orleans — all in Louisiana – sequence: 18 givenname: Benjamin surname: Springgate fullname: Springgate, Benjamin organization: From the Pennington Biomedical Research Center, Baton Rouge (P.T.K., C.K.M., R.L.N., J.W.A., K.D.D., E.F.M., P.J.B., W.D.J.), the Department of Medicine and Feist–Weiller Cancer Center, Louisiana State University Health Sciences Center, Shreveport (C.L.A., T.C.D.), and Ochsner Clinic Foundation, Center for Outcomes and Health Services Research (E.G.P.-H.) and Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute (C.J.L.), Ochsner Clinical School–University of Queensland School of Medicine (E.G.P.-H., C.J.L.), the Department of Medicine, Division of Endocrinology and Metabolism (T.K.T., V.F.) and the Department of Medicine, Section of General Internal Medicine and Geriatrics (J.G.), Tulane University Health Sciences Center School of Medicine, Southeast Louisiana Veterans Health Care System (T.K.T., V.F.), the College of Pharmacy, Xavier University of Louisiana (K.B.K., D.F.S.), and the Department of Internal Medicine, Louisiana State University School of Medicine, and Program in Health Policy and Systems Management, Louisiana State University School of Public Health (B.S.), New Orleans — all in Louisiana |
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| Cites_doi | 10.1186/1471-2458-9-88 10.1111/nyas.12004 10.1007/s13142-012-0168-x 10.1111/cob.12120 10.1111/obr.12212 10.1038/oby.2004.179 10.1056/NEJM199910073411501 10.1097/MLR.0b013e3182726c33 10.2337/dc06-0560 10.1016/j.jbi.2008.08.010 10.1016/j.cct.2018.02.002 10.1001/archinternmed.2012.1 10.1161/01.cir.0000437739.71477.ee 10.1056/NEJMoa1109220 10.1080/17513758.2010.508541 10.1038/oby.2008.224 10.1002/oby.22054 10.1016/j.cct.2011.07.002 10.1038/s41430-018-0202-2 10.1038/oby.2006.84 10.1056/NEJMoa1108660 10.1007/s13679-019-00341-5 10.15585/mmwr.mm6650a1 10.1038/oby.2008.653 10.2337/diacare.25.12.2165 10.1111/obr.12241 10.1038/oby.2011.140 10.1001/jama.2018.3060 10.1001/jama.2013.282546 10.18865/ed.28.1.43 10.4300/JGME-D-14-00710.1 10.1016/j.amjmed.2014.02.003 10.1038/oby.2011.230 10.1161/CIRCULATIONAHA.106.171016 10.1056/NEJMsr1606602 |
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| Notes | ObjectType-Article-2 SourceType-Scholarly Journals-1 content type line 14 ObjectType-Feature-3 ObjectType-Evidence Based Healthcare-1 ObjectType-Article-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3 We thank the patients and the members of the patient advisory boards, community monitoring board, and the project management committee (Chris Lodge and Ava Zebrick, M.S.), who contributed greatly to the design and conduct of the trial; the trial patients, assessment technicians, and health coaches, without whom this trial would not have been possible; Willie C. White III, M.P.H., and the David Raines Community Health Centers; Gary Wiltz, M.D., and the Teche Action Clinic sites; Michael G. Griffin and Robert Post, M.D., and the Daughters of Charity Services of New Orleans; the Ochsner Health System and Access Health Louisiana clinic sites; the data and safety monitoring board (Robert Ross, Ph.D. [chair], John Lefante, Ph.D., Michael Rolfson, M.D., and Chris Lodge) for overseeing patient safety and the overall conduct of the trial; and David B. Allison, Ph.D., Andrew W. Brown, Ph.D., Stephanie L. Dickinson, M.S., and Lilian Golzarri-Arroyo, M.S., of the Indiana University School of Public Health–Bloomington for reviewing and verifying the statistical methods and results of this project. |
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| References | Lauby-Secretan, B, Scoccianti, C, Loomis, D, Grosse, Y, Bianchini, F, Straif, K (r002) 2016; 375 Tronieri, JS, Wadden, TA, Chao, AM, Tsai, AG (r027) 2019; 8 Jensen, MD, Ryan, DH, Apovian, CM (r009) 2014; 129 Katzmarzyk, PT, Martin, CK, Newton, RL (r016) 2018; 67 Shook, RP, Hand, GA, Wang, X (r033) 2014; 127 Pagoto, SL, Schneider, KL, Oleski, JL, Luciani, JM, Bodenlos, JS, Whited, MC (r039) 2012; 20 Ogden, CL, Fakhouri, TH, Carroll, MD (r007) 2017; 66 r021 Guh, DP, Zhang, W, Bansback, N, Amarsi, Z, Birmingham, CL, Anis, AH (r005) 2009; 9 r022 (r018) 2002; 25 Smith, S, Seeholzer, EL, Gullett, H (r015) 2015; 7 Wadden, TA, Volger, S, Sarwer, DB (r028) 2011; 365 Kraschnewski, JL, Sciamanna, CN, Stuckey, HL (r011) 2013; 51 Katzmarzyk, PT, Most, J, Redman, LM, Rood, J, Ravussin, E (r034) 2018; 72 Rickman, AD, Williamson, DA, Martin, CK (r020) 2011; 32 Hamman, RF, Wing, RR, Edelstein, SL (r025) 2006; 29 Hales, CM, Fryar, CD, Carroll, MD, Freedman, DS, Ogden, CL (r001) 2018; 319 Blackman Carr, LT, Samuel-Hodge, C, Ward, DS, Evenson, KR, Bangdiwala, SI, Tate, DF (r035) 2018; 28 Wingo, BC, Carson, TL, Ard, J (r031) 2014; 15 Kaplan, LM, Golden, A, Jinnett, K (r012) 2018; 26 Pagoto, SL, Pbert, L, Emmons, K, Farber, D (r013) 2012; 2 Bennett, GG, Warner, ET, Glasgow, RE (r030) 2012; 172 Harris, PA, Taylor, R, Thielke, R, Payne, J, Gonzalez, N, Conde, JG (r017) 2009; 42 Carvajal, R, Wadden, TA, Tsai, AG, Peck, K, Moran, CH (r014) 2013; 1281 Jerome, GJ, Myers, VH, Young, DR (r036) 2015; 5 Jensen, MD, Ryan, DH (r008) 2014; 311 (r019) 2006; 14 Wadden, TA, Neiberg, RH, Wing, RR (r026) 2011; 19 Calle, EE, Thun, MJ, Petrelli, JM, Rodriguez, C, Heath, CW (r004) 1999; 341 r006 Appel, LJ, Clark, JM, Yeh, H-C (r029) 2011; 365 r024 West, DS, Elaine Prewitt, T, Bursac, Z, Felix, HC (r032) 2008; 16 Poirier, P, Giles, TD, Bray, GA (r003) 2006; 113 Wing, RR, Hamman, RF, Bray, GA (r038) 2004; 12 Thomas, DM, Martin, CK, Heymsfield, S, Redman, LM, Schoeller, DA, Levine, JA (r023) 2011; 5 Ma, J, Xiao, L, Stafford, RS (r010) 2009; 17 Williams, RL, Wood, LG, Collins, CE, Callister, R (r037) 2015; 16 e_1_3_5_28_2 e_1_3_5_27_2 e_1_3_5_26_2 e_1_3_5_25_2 e_1_3_5_24_2 e_1_3_5_23_2 e_1_3_5_22_2 e_1_3_5_21_2 e_1_3_5_29_2 e_1_3_5_2_2 e_1_3_5_40_2 e_1_3_5_8_2 e_1_3_5_20_2 e_1_3_5_7_2 e_1_3_5_9_2 e_1_3_5_4_2 e_1_3_5_3_2 e_1_3_5_6_2 e_1_3_5_5_2 e_1_3_5_17_2 e_1_3_5_39_2 e_1_3_5_16_2 e_1_3_5_38_2 e_1_3_5_15_2 e_1_3_5_37_2 e_1_3_5_14_2 e_1_3_5_36_2 e_1_3_5_12_2 e_1_3_5_35_2 e_1_3_5_13_2 e_1_3_5_34_2 e_1_3_5_10_2 e_1_3_5_33_2 e_1_3_5_11_2 e_1_3_5_32_2 e_1_3_5_19_2 e_1_3_5_18_2 e_1_3_5_31_2 e_1_3_5_30_2 32877588 - N Engl J Med. 2020 Sep 3;383(10):977-978 |
| References_xml | – volume: 17 start-page: 1077 year: 2009 end-page: 1085 ident: r010 article-title: Adult obesity and office-based quality of care in the United States. publication-title: Obesity (Silver Spring) – volume: 32 start-page: 874 year: 2011 end-page: 881 ident: r020 article-title: The CALERIE Study: design and methods of an innovative 25% caloric restriction intervention. publication-title: Contemp Clin Trials – volume: 25 start-page: 2165 year: 2002 end-page: 2171 ident: r018 article-title: The Diabetes Prevention Program (DPP): description of lifestyle intervention. publication-title: Diabetes Care ;The Diabetes Prevention Program (DPP) Research Group – volume: 15 start-page: 46 year: 2014 end-page: 61 ident: r031 article-title: Differences in weight loss and health outcomes among African Americans and whites in multicentre trials. ;:Suppl 4 publication-title: Obes Rev – volume: 8 start-page: 128 year: 2019 end-page: 136 ident: r027 article-title: Primary care interventions for obesity: review of the evidence. publication-title: Curr Obes Rep – volume: 16 start-page: 1413 year: 2008 end-page: 1420 ident: r032 article-title: Weight loss of black, white, and Hispanic men and women in the Diabetes Prevention Program. publication-title: Obesity (Silver Spring) – volume: 67 start-page: 1 year: 2018 end-page: 10 ident: r016 article-title: Promoting Successful Weight Loss in Primary Care in Louisiana (PROPEL): rationale, design and baseline characteristics. publication-title: Contemp Clin Trials – volume: 375 start-page: 794 year: 2016 end-page: 798 ident: r002 article-title: Body fatness and cancer — viewpoint of the IARC Working Group. publication-title: N Engl J Med – volume: 14 start-page: 737 year: 2006 end-page: 752 ident: r019 article-title: The Look AHEAD study: a description of the lifestyle intervention and the evidence supporting it. publication-title: Obesity (Silver Spring) ;The Look AHEAD Research Group – ident: r022 – volume: 2 start-page: 381 year: 2012 end-page: 383 ident: r013 article-title: The Society of Behavioral Medicine position statement on the CMS decision memo on intensive behavior therapy for obesity. publication-title: Transl Behav Med – volume: 1281 start-page: 191 year: 2013 end-page: 206 ident: r014 article-title: Managing obesity in primary care practice: a narrative review. publication-title: Ann N Y Acad Sci – volume: 127 start-page: 436 year: 2014 end-page: 442 ident: r033 article-title: Low fitness partially explains resting metabolic rate differences between African American and white women. publication-title: Am J Med – volume: 5 start-page: 342 year: 2015 end-page: 348 ident: r036 article-title: Psychosocial predictors of weight loss by race and sex. publication-title: Clin Obes – volume: 341 start-page: 1097 year: 1999 end-page: 1105 ident: r004 article-title: Body-mass index and mortality in a prospective cohort of U.S. adults. publication-title: N Engl J Med – volume: 66 start-page: 1369 year: 2017 end-page: 1373 ident: r007 article-title: Prevalence of obesity among adults, by household income and education — United States, 2011–2014. publication-title: MMWR Morb Mortal Wkly Rep – volume: 113 start-page: 898 year: 2006 end-page: 918 ident: r003 article-title: Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss: an update of the 1997 American Heart Association Scientific Statement on Obesity and Heart Disease from the Obesity Committee of the Council on Nutrition, Physical Activity, and Metabolism. publication-title: Circulation – volume: 5 start-page: 579 year: 2011 end-page: 599 ident: r023 article-title: A simple model predicting individual weight change in humans. publication-title: J Biol Dyn – volume: 12 start-page: 1426 year: 2004 end-page: 1434 ident: r038 article-title: Achieving weight and activity goals among Diabetes Prevention Program lifestyle participants. publication-title: Obes Res – volume: 365 start-page: 1969 year: 2011 end-page: 1979 ident: r028 article-title: A two-year randomized trial of obesity treatment in primary care practice. publication-title: N Engl J Med – volume: 19 start-page: 1987 year: 2011 end-page: 1998 ident: r026 article-title: Four-year weight losses in the Look AHEAD study: factors associated with long-term success. publication-title: Obesity (Silver Spring) – volume: 16 start-page: 171 year: 2015 end-page: 186 ident: r037 article-title: Effectiveness of weight loss interventions — is there a difference between men and women: a systematic review. publication-title: Obes Rev – volume: 319 start-page: 1723 year: 2018 end-page: 1725 ident: r001 article-title: Trends in obesity and severe obesity prevalence in US youth and adults by sex and age, 2007-2008 to 2015-2016. publication-title: JAMA – volume: 20 start-page: 1234 year: 2012 end-page: 1239 ident: r039 article-title: Male inclusion in randomized controlled trials of lifestyle weight loss interventions. publication-title: Obesity (Silver Spring) – volume: 9 start-page: 88 year: 2009 end-page: 88 ident: r005 article-title: The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. publication-title: BMC Public Health – volume: 42 start-page: 377 year: 2009 end-page: 381 ident: r017 article-title: Research electronic data capture (REDCap) — a metadata-driven methodology and workflow process for providing translational research informatics support. publication-title: J Biomed Inform – ident: r021 article-title: (http://www.partnershiphp.org/Providers/HealthServices/Documents/Health%20Education/CandLToolKit/2%20Manual%20for%20Clinicians.pdf) – ident: r006 – volume: 72 start-page: 920 year: 2018 end-page: 922 ident: r034 article-title: Energy expenditure and substrate oxidation in White and African American young adults without obesity. publication-title: Eur J Clin Nutr – volume: 311 start-page: 23 year: 2014 end-page: 24 ident: r008 article-title: New obesity guidelines: promise and potential. publication-title: JAMA – volume: 29 start-page: 2102 year: 2006 end-page: 2107 ident: r025 article-title: Effect of weight loss with lifestyle intervention on risk of diabetes. publication-title: Diabetes Care – volume: 51 start-page: 186 year: 2013 end-page: 192 ident: r011 article-title: A silent response to the obesity epidemic: decline in US physician weight counseling. publication-title: Med Care – volume: 7 start-page: 388 year: 2015 end-page: 394 ident: r015 article-title: Primary care residents’ knowledge, attitudes, self-efficacy, and perceived professional norms regarding obesity, nutrition, and physical activity counseling. publication-title: J Grad Med Educ – volume: 28 start-page: 43 year: 2018 end-page: 48 ident: r035 article-title: Racial differences in weight loss mediated by engagement and behavior change. publication-title: Ethn Dis – volume: 129 start-page: S102 year: 2014 end-page: S138 ident: r009 article-title: 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. ;:Suppl 2 publication-title: Circulation – volume: 26 start-page: 61 year: 2018 end-page: 69 ident: r012 article-title: Perceptions of barriers to effective obesity care: results from the national ACTION study. publication-title: Obesity (Silver Spring) – volume: 172 start-page: 565 year: 2012 end-page: 574 ident: r030 article-title: Obesity treatment for socioeconomically disadvantaged patients in primary care practice. publication-title: Arch Intern Med – ident: r024 article-title: Decision memo for intensive behavioral therapy for obesity. Baltimore: Centers for Medicare & Medicaid Services ( http://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?&NcaName=Intensive%20Behavioral%20Therapy%20for%20Obesity&bc=ACAAAAAAIAAA&NCAId=253& ) – volume: 365 start-page: 1959 year: 2011 end-page: 1968 ident: r029 article-title: Comparative effectiveness of weight-loss interventions in clinical practice. publication-title: N Engl J Med – ident: e_1_3_5_6_2 doi: 10.1186/1471-2458-9-88 – ident: e_1_3_5_15_2 doi: 10.1111/nyas.12004 – ident: e_1_3_5_23_2 – ident: e_1_3_5_14_2 doi: 10.1007/s13142-012-0168-x – ident: e_1_3_5_37_2 doi: 10.1111/cob.12120 – ident: e_1_3_5_32_2 doi: 10.1111/obr.12212 – ident: e_1_3_5_39_2 doi: 10.1038/oby.2004.179 – ident: e_1_3_5_5_2 doi: 10.1056/NEJM199910073411501 – ident: e_1_3_5_12_2 doi: 10.1097/MLR.0b013e3182726c33 – ident: e_1_3_5_26_2 doi: 10.2337/dc06-0560 – ident: e_1_3_5_7_2 – ident: e_1_3_5_18_2 doi: 10.1016/j.jbi.2008.08.010 – ident: e_1_3_5_22_2 – ident: e_1_3_5_17_2 doi: 10.1016/j.cct.2018.02.002 – ident: e_1_3_5_31_2 doi: 10.1001/archinternmed.2012.1 – ident: e_1_3_5_10_2 doi: 10.1161/01.cir.0000437739.71477.ee – ident: e_1_3_5_29_2 doi: 10.1056/NEJMoa1109220 – ident: e_1_3_5_25_2 – ident: e_1_3_5_24_2 doi: 10.1080/17513758.2010.508541 – ident: e_1_3_5_33_2 doi: 10.1038/oby.2008.224 – ident: e_1_3_5_13_2 doi: 10.1002/oby.22054 – ident: e_1_3_5_21_2 doi: 10.1016/j.cct.2011.07.002 – ident: e_1_3_5_35_2 doi: 10.1038/s41430-018-0202-2 – ident: e_1_3_5_20_2 doi: 10.1038/oby.2006.84 – ident: e_1_3_5_30_2 doi: 10.1056/NEJMoa1108660 – ident: e_1_3_5_28_2 doi: 10.1007/s13679-019-00341-5 – ident: e_1_3_5_8_2 doi: 10.15585/mmwr.mm6650a1 – ident: e_1_3_5_11_2 doi: 10.1038/oby.2008.653 – ident: e_1_3_5_19_2 doi: 10.2337/diacare.25.12.2165 – ident: e_1_3_5_38_2 doi: 10.1111/obr.12241 – ident: e_1_3_5_40_2 doi: 10.1038/oby.2011.140 – ident: e_1_3_5_2_2 doi: 10.1001/jama.2018.3060 – ident: e_1_3_5_9_2 doi: 10.1001/jama.2013.282546 – ident: e_1_3_5_36_2 doi: 10.18865/ed.28.1.43 – ident: e_1_3_5_16_2 doi: 10.4300/JGME-D-14-00710.1 – ident: e_1_3_5_34_2 doi: 10.1016/j.amjmed.2014.02.003 – ident: e_1_3_5_27_2 doi: 10.1038/oby.2011.230 – ident: e_1_3_5_4_2 doi: 10.1161/CIRCULATIONAHA.106.171016 – ident: e_1_3_5_3_2 doi: 10.1056/NEJMsr1606602 – reference: 32877588 - N Engl J Med. 2020 Sep 3;383(10):977-978 |
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| Snippet | In this cluster-randomized trial, carried out in an underserved population, the authors hypothesized that a high-intensity lifestyle intervention would result... Evidence of the effectiveness of treatment for obesity delivered in primary care settings in underserved populations is lacking. We conducted a... BackgroundEvidence of the effectiveness of treatment for obesity delivered in primary care settings in underserved populations is lacking.MethodsWe conducted a... Evidence of the effectiveness of treatment for obesity delivered in primary care settings in underserved populations is lacking.BACKGROUNDEvidence of the... |
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| SubjectTerms | Adult Age Aged Biomedical research Body weight Body weight loss Cardiovascular disease Clinics Collaboration Diabetes Diet, Reducing Energy intake Exercise Female Gastrointestinal surgery Health Literacy Healthcare Disparities Healthy Lifestyle Humans Hypotheses Hypothesis testing Intervention Lifestyles Male Middle Aged Nutrition Obesity Obesity - ethnology Obesity - physiopathology Obesity - therapy Patient Education as Topic Patient-centered care Patients Physical activity Population Primary care Primary Health Care Socioeconomic Factors Vulnerable Populations Weight control Weight Loss Young Adult |
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| Title | Weight Loss in Underserved Patients — A Cluster-Randomized Trial |
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