Weight Loss Services Research Articles

Weight control efforts and practices and health professional advice: a cross-sectional national survey in England

ObjectivesThere is evidence that general practitioners (GPs) can increase the uptake of weight management programmes that enhance weight loss compared with self-directed efforts, but the rate at which they do...

GLP-1 RA Prescribing Errors in a Multidisciplinary Digital Weight-Loss Service: A Retrospective Quantitative Analysis.

Digital weight loss services (DWLSs) that use Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have demonstrated potential in contributing to a shift in global obesity rates. However, reasonable concerns have been raised about the prescribing safety of these services. Prior to this study, electronic prescribing safety had only been investigated in hospital settings and community clinics. This study retrospectively analyzed prescribing errors committed over a 6-month period in 2023 at Australia's largest GLP-1 RA-supported DWLS. The analysis found that 1654 (4.4%) of the 37323 audited GLP-1 RA prescriptions contained an error. Most errors pertained to insufficient safety counselling (49.15%) and inadequate investigations of potential contraindications (30.29%). Although a large portion of prescribing errors were detected via the automated query method (64.9%), the other three auditing methods all detected a significant number of true errors (>100). Patients from the highest body mass index category (40+ kg/m2) were overrepresented in the service's prescribing error data. These findings lay a vital foundation in the emerging literature on GLP-1 RA-supported DWLSs.

Effectiveness and Side Effect Incidence in a Real-World Digital Weight-Loss Service Using Compounded Semaglutide: A Retrospective Comparative Study

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) were originally developed in the late 1980s as a class of antidiabetic medication. However, research over the past decade has found them to be a safe and effective weight-loss agent, which has led to the approval of GLP-1 RAs such as Semaglutide as a supplement to lifestyle obesity interventions in multiple countries. When Semaglutide has become commercially unavailable, digital weight-loss services (DWLSs) have prescribed a compounded form of the medication—a practice in which health professionals formulate a replica of the commercial medication to serve ongoing patient needs. Although compounding has been relatively common over the past century, prominent medical bodies have argued that compounding a relatively novel medication such as Semaglutide represents a major safety risk. This study retrospectively compared the weight and side effect outcomes of patients from a large Australian DWLS whose lifestyle coaching was supplemented with either compounded or pure Semaglutide (both groups following the same titration schedule). All data were extracted from the service’s central data repository. To be included in the weight loss analysis, patients needed to have received a minimum of four monthly medication orders between June 2023 and May 2024 and have submitted weight data between 90 and 150 days after the arrival of their first order. All patients who received at least one medication order within the same period were included in the side effect analysis. The mean four-month weight loss percentage was statistically lower in the compounded Semaglutide group (N = 923, M = 9.11, SD = ±5.76) compared to those in the pure Semaglutide group (n = 1858, M = 9.87, SD = ±6.46), t (2032) = −3.15, p = 0.0017. A statistically lower proportion of patients in the compounded Semaglutide group (71.61%) reported at least one side effect than patients in the pure Semaglutide group (77.40%) during the study period, X2 (1, N = 7683) = 32.32, p < 0.001. When side effects were disaggregated into severity categories, a statistical difference was only observed in mild side effects, X2 (1, N = 7683) = 59.16, p < 0.001. A significantly higher rate of patients from the pure Semaglutide group achieved the ten (50.54% vs. 44.64%), X2 (1, N = 7683) = 10.34, p < 0.001, and fifteen (21.42% vs. 12.78%), X2 (1, N = 7683) = 30.43, p < 0.001, percent weight loss thresholds than patients from the compounded Semaglutide group. The findings indicate that compounded Semaglutide can be used as a component of tightly controlled DWLSs with slightly less effectiveness and but with slightly lower side effect incidence when compared to pure Semaglutide.

The Dispensing Error Rate in an App-Based, Semaglutide-Supported Weight-Loss Service: A Retrospective Cohort Study.

Digital weight-loss services (DWLSs) combining pharmacotherapy and health coaching have the potential to make a major contribution to the global struggle against obesity. However, the degree to which DWLSs compromise patient safety through the dispensation of Glucagon-like peptide-1 receptor agonist (GLP-1 RA) medications is unknown. This study retrospectively analysed the rate at which patients reported GLP-1 RA dispensing errors from patient-selected and partner pharmacies of Australia's largest DWLS provider over a six-month period. The analysis found that 99 (0.35%) of the 28,165 dispensed semaglutide orders contained an error. Incorrect dose (58.6%) and unreasonable medication expiry window (21.2%) were the two most common error types. Most errors (84.9%) were deemed to have been of medium urgency, with 11.1% being considered high-urgency errors. Incorrect doses (45.5%) and supplies of the wrong medication (36.3%) comprised most errors reported in high-urgency cases. Female patients reported more dispensing errors than male patients (0.41% vs. 0.12%, p < 0.001). Similarly, reported dispensing error rates were highest among patients aged 18 to 29 years (0.6%) and 30 to 39 years (0.5%). This research provides preliminary evidence that GLP-1 RA dispensing errors within comprehensive Australian DWLSs are relatively low.

The effectiveness and sustainability of health outcomes from a holistic digital weight-loss service with concomitant initiation of tirzepatide: A pragmatic randomized controlled trial in the UK.

To measure the effectiveness and sustainability of the Juniper UK digital weight-loss service (DWLS), which delivers 6 months of personalized, proactive lifestyle coaching supplemented with tirzepatide to patients through a multidisciplinary team (MDT). An observer-blinded randomized controlled trial (RCT) will be conducted on a cohort of non-diabetic patients of the Juniper DWLS in the UK. Participants in both the intervention and control groups will receive weekly subcutaneous injections of 2.5 mg tirzepatide for 4 weeks, uptitrating the dose to 5.0 mg from weeks 5 to 8, and by 2.5 mg every 4 weeks until reaching 15 mg in week 21, which they will maintain until the end of the intervention period at 6 months, when participants will be taken off the medication. The intervention group will receive personalized weeklylifestyle coaching with a focus on protein intake and resistance training for 6 months. Participants in the control group will attend a diet and exercise group counselling session at programme inception and will be sent a summary of the session's content at months 2 and 4. Aside from these events, health coaches will only interact with control group participants on a reactive basis. From month 6 to month 12, participants from both groups will no longer have access to their MDTs. The trial's co-primary endpoints include weight loss, fat-free to fat-mass ratio and composite strength measures at 12 months (6 months following the end of treatment), compared with baseline. Secondary endpoints include percentage change in weight, fat-free to fat-mass ratio, and composite strength from baseline to 6 months, side effect incidence, and change in cardiometabolic risk factors at 12 months. Quality of life and programme engagement represent the study's exploratory endpoints. A total of 688 participants enrolled in the study, with a mean age of 44.6 (± 11.4) years and a mean body mass index of 34.8 (± 7.5) kg/m2; 81.0% of participants are women, and 72.8% are of White ethnicity. More than three-quarters of participants have at least one co-morbidity, with dyslipidaemia (42.4%), hypertension (35.3%) and high cholesterol (31.8%) being the most prevalent conditions. This RCT will be the first to assess the effectiveness and sustainability of a real-world intensive, multidisciplinary DWLS, and it should highlight the potential of such a service for long-term obesity treatment compared with programmes that deliver standard health counselling.

Evidence Over Ego: How Australian Private Digital Weight-Loss Services Need to Respond to Continual Scepticism from Prominent Medical Bodies

Evidence Over Ego: How Australian Private Digital Weight-Loss Services Need to Respond to Continual Scepticism from Prominent Medical Bodies

Effectiveness of an Email-Based, Semaglutide-Supported Weight-Loss Service for People with Overweight and Obesity in Germany: A Real-World Retrospective Cohort Analysis

Quality glucose-like peptide-1 receptor agonist (GLP-1 RA)-supported digital weight-loss services (DWLSs) have the potential to play a significant role in shifting the alarming global obesity rate. Previous studies have demonstrated various aspects of their utility in Australian and British populations, but nothing has hitherto been investigated in real-world European settings, where GLP-1 RA weight therapy and digital healthcare are widely used. This study retrospectively analysed the 5-month (Mean = 160.14 days) weight-loss outcomes in a cohort of patients who received email-based health coaching and Semaglutide therapy via the Juniper Germany DWLS (n = 833). Mean weight loss was 9.52 (±5.46) percent, with 81.51% of the cohort losing a ‘meaningful’ (5% or more) amount of weight. Females (Mean = 9.75) tended to lose more weight than males (Mean = 8.41) and patients from the lowest two BMI categories (27.5–29.99 kg/m2 Mean = 10.1; 30–34.99 kg/m2 Mean = 9.74) lost significantly more weight than those in the highest BMI category (≥40 kg/m2 Mean = 8.11). These findings indicate that GLP-1 RA-supported DWLSs can contribute to meaningful weight loss in Germany. Future research should seek to conduct a dedicated adherence analysis of the Juniper Germany DWLS and measure the effect of subsidisation and baseline body mass index on general DWLS effectiveness.

US Military Veteran Perspectives on Eating Disorder Screening, Diagnosis, and Treatment: A Qualitative Study.

We aimed to explore US veteran perspectives on eating disorder screening, diagnosis, patient-provider conversations, and care in the Veterans Health Administration (VHA). Rapid qualitative analysis of 30-45 min phone interviews with 16 (N = 16) veterans with an electronic health record ICD-10 eating disorder diagnosis, who received care at one of two VHA healthcare systems in Connecticut or California. Topics covered included: conversations with providers about eating disorder symptoms, diagnosis, and referral to treatment; feedback about an eating disorder screener, and; reflections on eating disorders among veterans and VHA's effort to address them. Most veterans reported difficulty understanding and defining the problems they were experiencing and self-diagnosed their eating disorder before discussing it with a provider. Treatment referrals were almost universally for being overweight rather than for an eating disorder, often leading veterans to feel misunderstood or marginalized. Overall, veterans were enthusiastic about the screener, preferred screening to be conducted by primary care providers, and noted that conversations needed to be non-stigmatizing. There was consensus that VHA is not doing enough to address this issue, that group support and therapy could be beneficial, and that resources needed to be centralized and accessible. For the most part, veterans felt that, at best, eating disorders and disordered eating are overlooked, and at worst, conflated with overweight. The majority of veterans got referred for weight loss or weight management services but would welcome the opportunity to be screened for, and referred to, eating disorder treatment.

Patient Adherence to a Real-World Digital, Asynchronous Weight Loss Program in Australia That Combines Behavioural and GLP-1 RA Therapy: A Mixed Methods Study.

Increasingly large numbers of people are using digital weight loss services (DWLSs) to treat being overweight and obesity. Although it is widely agreed that digital modalities improve access to care in general, obesity stakeholders remain concerned that many DWLSs are not comprehensive or sustainable enough to deliver meaningful health outcomes. This study adopted a mixed methods approach to assess why and after how long patients tend to discontinue Australia's largest DWLS, a program that combines behavioural and pharmacological therapy under the guidance of a multidisciplinary care team. We found that in a cohort of patients who commenced the Eucalyptus DWLS between January and June 2022 (n = 5604), the mean program adherence was 171.2 (±158.2) days. Inadequate supplying of a patient's desired glucose-like peptide-1 receptor agonist medication was the most common reason for discontinuation (43.7%), followed by program cost (26.2%), result dissatisfaction (9.9%), and service dissatisfaction (7.2%). Statistical tests revealed that ethnicity and age both had a significant effect on patient adherence. These findings suggest that DWLSs have the potential to improve access to comprehensive, continuous obesity care, but care models need to improve upon the one observed in the Eucalyptus Australia DWLS to mitigate common real-world program attrition factors.

‘Life changing or a failure’? Qualitative experiences of service users from the weight maintenance phase of the NHS Low Calorie Diet Programme pilot for type 2 diabetes

Background: The weight maintenance phase of the NHS Low CalorieaDiet (LCD) programme focuses on embedding long- term dietary and physical activity changes. Understanding individual experiences of this phase is crucial to exploring long- term effectiveness and equity of the intervention approach. Methods: This was a coproduced qualitative study underpinned by a realist informed approach, using interviews and photovoice techniques. Service users (n=25) of the NHS LCD programme were recruited from three delivery models, across 21 sites in England. Data were analysed using a thematic approach. Results: The experiences reported were largely positive, with many participants reporting changes in their diet and physical activity. Some service users expressed a need for additional support and there appeared variation in their experiences of the service providers and the wider available support network. Fear of weight regain and its glycaemic consequences was expressed by many; various mitigations were employed, including participating in other weight loss services and continuing use of Total Diet Replacement products. Conclusions: The NHS LCD programme has been life-changing for some people. However, service user insights suggest that a stronger person-centred focus might further improve effectiveness and service user experience.

Implementation of a pharmacist-led weight loss service to improve medication access and weight loss

BackgroundObesity is a prevalent medical condition that can contribute to an increased risk of developing serious comorbidities, leading to an increase in hospitalizations, morbidity, and mortality. Many of these medical conditions can be improved with weight loss. ObjectivesThis project was designed to improve weight loss outcomes and assess the utilization of services provided by clinical pharmacists for collaborative weight loss management. MethodsThe study design was a single-center, retrospective, and quality improvement study within 3 outpatient clinics at Tufts Medical Center. Patients referred to the pharmacist-led weight loss service from September 1 to October 31, 2022, and continued care for up to 6 months were included. Pharmacist services included selection of weight loss medication, assistance with medication access, device teaching and dose titration, lifestyle counseling, and follow-up. The primary outcome was percent weight loss from baseline. ResultsSeventy-nine patients were referred to the pharmacist-led weight loss service. Mean age of patients was 51 years (SD ±13). Sixty-one patients were female (77.2%). Median baseline weight was 105.5 kg (IQR 93.1 to 120.5 kg) and body mass index 38.1 kg/m2 (IQR 33.9 to 43.5 kg/m2). The median percent weight loss from baseline through the end of the study duration was −8.0% (IQR -3.1 to −12.1%). ConclusionPharmacists were able to effectively provide weight loss care through a pharmacist-led weight loss service by aiding in medication access, providing education on devices and lifestyle management, and engaging in frequent follow-up. Future directions of this study include expansion of the pharmacist-led weight loss service to other ambulatory care clinics within TMC.

Patient Satisfaction with an Australian Digital Weight-Loss Service: A Comparative Retrospective Analysis

Patient Satisfaction with an Australian Digital Weight-Loss Service: A Comparative Retrospective Analysis

Impact of a pharmacist-led weight management service in a cardiology clinic

BackgroundGlucagon-like peptide-1 receptor agonists (GLP-1 RAs) for weight management require frequent dose titration, patient education, and insurance coverage navigation, which pharmacists are well equipped to manage. Data are lacking regarding the benefit of a pharmacist-managed service using GLP-1 RAs for weight loss in a high-risk cardiac population. ObjectiveThis study aimed to evaluate the impact of a pharmacist-led weight loss service within a cardiology clinic using GLP-1 RAs and lifestyle counseling in patients with overweight and obesity. Practice descriptionAn outpatient cardiology clinic employs clinical pharmacists who use collaborative practice agreements to provide cardiovascular risk reduction services that did not include weight management at baseline. Practice innovationThis is the first description of a pharmacist-led weight management clinic using solely GLP-1 RAs in a cardiology practice. Patients were referred to the clinical pharmacist, who initiated and titrated GLP-1 RA and provided lifestyle counseling. Evaluation methodsThis was a single-center, prospective, pre-post analysis of adults with a body mass index of at least 30 kg/m2 or 27 kg/m2 with a weight-related comorbidity, with a preceding failed dietary effort and insurance coverage for semaglutide (Wegovy, Novo Nordisk) or liraglutide (Saxenda, Novo Nordisk) and managed by a pharmacist. The primary outcome was patients achieving ≥ 5% weight loss at 6 months, assessed via descriptive statistics. ResultsBetween March 2022 and March 2023, 204 patients were referred by their cardiologist, and 59 patients started treatment with semaglutide (Wegovy, Novo Nordisk) or liraglutide (Saxenda, Novo Nordisk). A total of 31 patients completed 6 months of treatment at time of study completion, and all achieved ≥ 5% weight loss at 6 months, with a mean weight loss of 12.6%. Glycated hemoglobin improved by 0.6%, low-density lipoprotein by 18 mg/dL, triglycerides by 29 mg/dL, systolic blood pressure by 9 mm Hg, and diastolic blood pressure by 2 mm Hg. ConclusionPharmacist-led management of GLP-1 RA in patients with obesity or overweight led to clinically meaningful weight loss and improvements in weight-related comorbidities.

Protocol for a pragmatic trial testing a self-directed lifestyle program targeting weight loss among patients with obstructive sleep apnea (POWER Trial)

BackgroundObesity comprises the single greatest reversible risk factor for obstructive sleep apnea (OSA). Despite the potential of lifestyle-based weight loss services to improve OSA severity and symptoms, these programs have limited reach. POWER is a pragmatic trial of a remote self-directed weight loss care among patients with OSA. MethodsPOWER randomizes 696 patients with obesity (BMI 30–45 kg/m2) and recent diagnosis or re-confirmation of OSA 1:1 to either a self-directed weight loss intervention or usual care. POWER tests whether such an intervention improves co-primary outcomes of weight and sleep-related quality of life at 12 months. Secondary outcomes include sleep symptoms, global ratings of change, and cardiovascular risk scores. Finally, consistent with a hybrid type 1 approach, the trial embeds an implementation process evaluation. We will use quantitative and qualitative methods including budget impact analyses and qualitative interviews to assess barriers to implementation. ConclusionsThe results of POWER will inform population health approaches to the delivery of weight loss care. A remote self-directed program has the potential to be disseminated widely with limited health system resources and likely low-cost.

Letter from the Editor

Bariatric Surgical Practice and Patient CareVol. 18, No. 2 EditorialFree AccessLetter from the EditorDean J. MikamiDean J. MikamiDean J. Mikami, MD, FACS, Editor-in-Chief, Bariatric Surgical Practice and Patient Care, Professor of Surgery, Associate Chair of Clinical Affairs, Division Chief, General Surgery, Associate Program Director, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI 96813, USA E-mail Address: dmikami2@hawaii.eduDepartment of General Surgery, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA.Search for more papers by this authorPublished Online:15 Jun 2023https://doi.org/10.1089/bari.2023.29034.djmAboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail Since our last issue, we have continued to receive high-quality articles from around the world. I again want to thank our dedicated peer review physicians, surgeons, and allied health professionals for their many hours of work. I also want to thank William F. Gourash, CRNP, PhD, Chih-Kun Huang, MD, and Melissa A. Kalarchian, PhD who will be rotating off our editorial board. Their many years of dedication to Bariatric Surgical Practice and Patient Care has moved the journal forward and we wish them the best in their future endeavors. I want to welcome two new members to the board at this time. Dr. Jennifer Schwartz is an assistant professor of surgery in the division of bariatric and minimally invasive surgery at the Yale School of Medicine. Dr. Schwartz earned her BS from Vanderbilt University and MD from SUNY Upstate Medical University.She then completed her general surgical residency and minimally invasive surgical fellowship at The Ohio State University Wexner Medical Center in Columbus, Ohio. Dr. Sara Martin del Campo who most recently received the 2022 Bariatric Surgery Top Doc designation. Sara E. Martin del Campo, MD, is a metabolic and bariatric surgeon with Swedish Weight Loss Services at First Hill and Issaquah. Dr. Martin del Campo is a board-certified general surgeon and fellowship-trained bariatric surgeon. She has studied clinical outcomes in surgery and has authored multiple peer-reviewed publications in the field, and she continues to participate on committees of many national societies, including the American Society for Metabolic and Bariatric Surgery and The Society of American Gastrointestinal and Endoscopic Surgeons.In this issue, we have a wide variety of articles from around the world. Our lead study is from Dr. Andrew Strong titled “Use of Acid Suppression Therapy Following Gastric Bypass and Sleeve Gastrectomy a Long-Term Follow up.” Bariatric Surgical Practice and Patient Care continues to hold a strong international presence as we have publications from six different countries represented in this issue.In closing, I hope you consider publishing your next study in Bariatric Surgical Practice and Patient Care. The journal is always open to innovative ways of improving the reader's experience. Please feel free to contact me if you have any suggestions that could improve our journal.Sincerely,FiguresReferencesRelatedDetails Volume 18Issue 2Jun 2023 InformationCopyright 2023, Mary Ann Liebert, Inc., publishersTo cite this article:Dean J. Mikami.Letter from the Editor.Bariatric Surgical Practice and Patient Care.Jun 2023.65-65.http://doi.org/10.1089/bari.2023.29034.djmPublished in Volume: 18 Issue 2: June 15, 2023PDF download

Development and Pilot Testing of a Telehealth Weight Loss Program

ABSTRACT Introduction/Purpose Behaviorally based in-person multidisciplinary programs for weight loss have been studied for decades; however, delivery, scalability, and accessibility remain a challenge. We report pilot findings from a new asynchronous protocol-based telehealth weight loss program. Methods This 12-wk single-arm pilot study included adults (18–65 yr old) with body mass index (BMI) of 25–40 kg·m−2. The Home Weight Loss (HWL) program consisted of weekly app- and e-mail-delivered lesson modules covering traditional diet, exercise, and behavioral topics for weight loss. Daily weight and activity level were monitored automatically via a wireless scale and an activity tracker, and participants logged their caloric intake into the system. Monitoring data were reviewed weekly by clinicians who provided brief video-recorded feedback for participants to view at their convenience. Weight and height were measured in person at baseline and postintervention. Postintervention participants completed a satisfaction survey. Results Thirty participants (70% female; 80% White; mean age = 41 yr, standard deviation (SD) = 13.7 yr; mean BMI = 32.4 kg·m−2, SD = 4.3 kg·m−2) were enrolled, and 27 provided posttreatment data. Percent weight loss was 4.12% (SD = 4.22%). Overall, 93% of participants reported being satisfied with their overall experience in the program, and 59% cited individualized feedback as a benefit of the program. Conclusions The HWL program produced modest weight loss and demonstrated feasibility and participant acceptability. This model appears to be generally scalable for broader use and can be used to extend weight loss services for those not residing near medical centers and those in need of asynchronous and virtual feedback.

‘Out of sync’: a qualitative investigation of patients’ experiences of atrial fibrillation and perceptions of weight management

ObjectivesTo explore ways to enhance the design of risk factor management and weight-loss services for people with overweight/obesity and atrial fibrillation (AF).BackgroundAF is the most common cardiac arrhythmia, with serious...

Keep fighting or give up? An investigation of consumer regret over repetitive failures in weight loss services

PurposeWeight loss services feature high consumer involvement that is sometimes marked by repetitive failures. These features can affect regret and its associated factors differently from the way that discrete failure can. The purpose of this study is to investigate consumer regret over repetitive failures in weight loss services as well as its antecedents (overeating and insufficient exercise), consequences (rumination and reflection) and moderators (failure experiences and required effort). This study also investigates how rumination and reflection affect persistence intention.Design/methodology/approachA total of 318 samples were collected through three surveys, one of which contained a scenario, provided to consumers who experienced repetitive failures in weight loss. The proposed relationships were tested using structural equation modeling, dominance analysis and PROCESS modeling.FindingsThe results of this study reveal that overeating contributes to regret more saliently than does insufficient exercise. The effect of regret on rumination (thoughts about continuing to blame oneself and giving up the pursuit of goals) is stronger than on reflection (thoughts about learning from prior failures and willingness to try again), and greater reflection results in higher persistence intention. Moreover, the effect of insufficient exercise on regret and the effect of regret on rumination are augmented with cumulative failure experiences, whereas required effort enhances the impact of regret on reflection.Originality/valueThis study is the first to focus on regret over repetitive failures in weight loss. It advances the literature by clarifying the antecedents and consequences of regret, showing how failure experiences influence the relationships between regret and its associated factors as well as identifying interventions that benefit from regret.

Impact of a pharmacist-run weight loss medication management service

BackgroundWeight loss medications have been shown to be effective for weight loss and reducing disease state risk in patients who are overweight or obese. However, it is unknown what impact pharmacists have on weight loss when providing medication management services. ObjectiveTo evaluate weight loss outcomes and clinic utilization of a pharmacist-run weight loss pharmacotherapy service at the VA Tennessee Valley Healthcare System (TVHS) in Nashville, TN. Practice descriptionPatients enrolled in the MOVE! weight loss program were referred to a clinical pharmacy specialist (CPS) who was able to assess comorbidities, prescribe weight loss medication, and provide ongoing follow-up via telehealth visits. Practice innovationThis is the first description of a pharmacist-run weight loss pharmacotherapy clinic. This model expanded the role of pharmacists at TVHS, where CPS involvement was previously limited to chart reviews when medication recommendations were requested. EvaluationThis prospective quality improvement project evaluated patients seen by the CPS in the first 6 months of clinic implementation. Primary outcomes included change in weight and proportion of patients with at least 5% weight loss at the end of the study period. Results were compared with patients seen by preventative medicine providers (PMPs) in the same time frame. ResultsA total of 79 patients were seen in the CPS clinic, and 40 met inclusion criteria. The clinic utilization rate was 100%. Mean weight change was −3.6 ± 5.7 kg (P < 0.001), and 25% of patients followed up by the CPS lost at least 5% body weight. In the PMP clinic, 29 patients demonstrated a mean weight change of −1.6 ± 6.0 kg (P = 0.15 compared with baseline), and 17.2% lost at least 5% body weight. ConclusionThis pharmacist-led weight loss clinic demonstrated statistically significant reductions in weight and was able to expand access to care for patients seeking weight loss services.

The Impact of a Clinical Pharmacist in an Interdisciplinary Weight Loss Service: A Follow-Up Study.

Background: At an Internal Medicine outpatient clinic, patients are referred to a weight loss service by their primary care physician to be managed by a clinical pharmacist and dietician. Objective: A study was conducted to determine the impact of this established, interdisciplinary, pharmacist-driven weight loss service on percent weight loss from baseline in patients who are obese or overweight compared to those receiving standard weight loss care. Methods: This was a retrospective, single-center, cohort study including adults ≥18 years of age with BMI ≥30 or BMI ≥27 with at least one weight-related comorbidity such as hypertension, dyslipidemia, or type 2 diabetes mellitus, and referred to the clinic's weight loss service or managed by their primary care physician. The primary outcome was percent weight loss from baseline. Key secondary outcomes included number of patients who had >5% weight loss in 6 months, number of patients who received liraglutide after 6 months, and percent weight loss in patients prescribed liraglutide. Statistical analysis included descriptive statistics, t-test for continuous outcomes, and chi-square test for between-group differences. Results: A total of 86 patients met inclusion criteria with 43 patients in the weight loss service group (intervention) and 43 patients in the primary care group (standard care). The intervention group had a significantly higher baseline weight and BMI than the standard care group (120.44kg vs. 95.72kg, p <0.001 and 45.34kg/m2 vs. 37.62kg/m2, p <0.001 respectively). The percent change in weight from baseline in the intervention group was a decrease of 3% compared to a decrease of 0.35% in the standard care group (p=0.03). Conclusions: Involvement of clinical pharmacist in interdisciplinary weight loss management through pharmacotherapy and other medication related services, shows considerable improvement in weight loss, when compared to the standard care of weight management. However, prospective randomized studies are warranted to further assess the benefits of a pharmacist-driven, interdisciplinary weight loss service.