Obesity Management via Telemedicine Shared Medical Appointments

Obesity as a chronic disease has reached pandemic proportions. The prevalence of obesity between 2017-2018 was 42.4%, and the national healthcare cost on obesity amounts to $149.4 billion annually. Current strategies for weight management are limited to lifestyle changes, anti-obesity medications (AOM), and bariatric surgeries. However, all of these treatment options are grossly underutilized with weight loss counseling occurring in fewer than 5.8% of primary care visits and only 0.8% of eligible patients receive AOM’s. Shared medical appointments (SMA) have emerged as a potential option to address the obesity pandemic, allowing patients to convene with a team of multidisciplinary providers in a group setting. There are few studies on the use of SMA’s in obesity management and even fewer studies assessing the efficacy of telemedicine SMA’s. Here we present a study examining the weight loss impact of telemedicine SMA’s through Program for Reducing Obesity (PRO), our institutional weight management clinic.

Methods:

Patients age ≥18 years with body mass index (BMI) ≥30 kg/m² were referred from the community to PRO at the UCLA Thousand Oaks clinic. In addition to individual clinic visits, patients participated in weekly SMA group classes for counseling and education via video conference led by an obesity medicine board certified endocrinologist and a registered dietician. Enrollment period spanned from May 2020 to May 2021. Primary outcomes were change in body weight and percent body fat at 3 months and 6 months. Secondary outcome includes percentage of patients who achieved 5% weight loss.

Results:

Thirty-two patients (mean age 62.1 years, 78% women, mean weight 97.6kg, mean BMI 35.6 kg kg/m²) were analyzed, with 27 patients completing at least 4 SMA sessions. Patients achieved on average a weight loss of 3.5% at 3 months and 4.9% at 6 months. By 6 months, 34.4% of the patients reached weight loss of ≥5%. Patients also achieved on average a 0.7% decrease in body fat at 3 months and 2.8% at 6 months. Overall 18.8% of participants were taking AOM by 6 months.

Discussion/Conclusion:

Our study demonstrates that telemedicine SMA’s can be an efficient and effective approach to obesity management.