Reducing Obesity Rates Among Adults in a Primary Care Setting: An Evidence-Based Practice Project

Abstract

Background: Over 60% of adults in the United States meet the criteria for being overweight or obese. The estimated obesity-related health care costs are as high as $147 billion per year. Despite the alarming health risks and increasing health care costs, the rates of screening and counseling for obesity in the primary care setting are merely 30%. This project outlines weight-management counseling strategies. Purpose of Project: The purpose of the evidence-based practice project was to implement patient-tailored evidence-based nutritional assessment tools and intensive behavioral counseling. The ultimate goal was to reduce body mass index (BMI) among overweight and obese patients by 5%. Evidenced-Based Interventions: The target population for this project was patients 18 years of age and older with a BMI above 25. Project participants (N = 20) were recruited and enrolled from July 2020-December 2020. During the project, participants completed a nutritional assessment interview and behavioral counseling sessions at the clinic location and phone. A trained, multidisciplinary team of nurse practitioners, physicians, and medical assistants assisted in implementing customized behavioral counseling. Clinic follow-up, phone-call interviews, and behavioral counseling were performed on selected patients once a month for six months. The patient's height, weight, and BMI were recorded in the electronic health record every month for data collection and evaluation. Systematic reviews report that nutritional assessment and behavioral counseling can reduce BMI by 5%-10% and assist in weight loss. Evaluation/Results: Six months after implementing an evidence-based practice project with customized motivational nutritional tools and intensive behavioral counseling, 50% of patients achieved weight loss. An average reduction in BMI was 1.2%. Implications for Practice: The project demonstrates success in weight reduction and health improvement in a select patient population. The sustainability of the project should result in significant cost savings. Conclusions: Tailored evidence-based nutritional assessment and motivational, intensive behavioral counseling in a primary care setting is feasible and can reduce BMI among overweight and obese patients.