Evaluating the Efficacy of an Intensive Medical Weight Management Program

Abstract

Introduction: Gastroenterologists are increasingly involved in obesity management. The aim of this study is to report the percent of patients enrolled in an intensive medical weight management program (IMWMP) who achieved therapeutic goal of 10% weight loss and maintained their decreased body weight. Methods: Our IMWMP involved visits every two to four weeks with medical providers, a recommended low carbohydrate diet with individualized goal carbohydrates often fewer than 100 g per day, encouraging physical activity, pharmacotherapy for some patients and surveillance every three months with bioelectric impedance analyzer. Our IMWMP is divided into two phases: phase 1 to achieve 10% weight loss and phase 2 to achieve each patient's self-desired goal weight with efforts to maintain weight loss in both phases. Starting with the onset of IMWMP in 2015, we retrospectively chart reviewed the first 225 patients enrolled. Patients with fewer than three visits with medical providers were excluded. Any patient with a visit between March to May 2018 was deemed to be an active enrollee. Results: 160 patients met inclusion criteria, of which 78 were active enrollees. The mean weight at the time of joining IMWMP and most recent office visit were 238.8 lbs and 214.6 lbs, respectively, for a mean weight loss of 24.2 lbs (-10.1%) (Image 1). Mean carbohydrate intake was 63.28 grams per day. During the first six months of enrollment, the mean decrease in weight was 14.5 pounds at three months and 21.6 lbs at six months (Image 2). 105 patients met the phase 1 goal and achieved initial weight loss of at least 10%, in a mean duration of 0.52 years (Image 3). Patients who lost at least 10% of their weight were able to maintain their lower body weight for a mean duration of 1.16 years based off their most recent office visit, with 56 active enrollees either maintaining or exceeding 10% weight loss. 36 patients attained initial weight loss of 20% or greater with 23 patients maintaining weight loss greater than 20% at time of their most recent office visit (Image 3). 11 patients reached their phase 2 goals and achieved it in mean duration of 1.20 years. Conclusion: A majority of patients enrolled in an IMWMP attained therapeutic success of at least 10% weight loss with many able to maintain their decreased weights. Given the tremendous personal and societal costs of obesity, including those of associated gastrointestinal disorders, such programs may have the potential to improve morbidity and mortality.1040_A Figure 1. Provides data about patient enrollment and goals achieved by our patients.1040_B Figure 2. Shows the mean weight over time. n represents the number of patients who were enrolled at the particular time.1040_C Figure 3. Shows the percentage of weight change based off the lowest weight and weight at most recent office visit.