For years, primary care providers have been helping patients manage several often-serious health problems resulting from obesity – from Type 2 diabetes and sleep apnea to hypertension and depression. But now, UCHealth is the first health system in the nation to prioritize weight loss discussions in the primary care setting in an attempt to tackle the underlying cause of these problems.
Doctors and researchers at UCHealth and the University of Colorado School of Medicine built a process called PATHWEIGH that facilitates clinicians providing and patients receiving care for excess body weight. PATHWEIGH is not a weight loss program. Instead, it enables primary care providers to deliver highly individualized care for patients with obesity according to their needs and preferences.
“When our patients go to any of our primary care clinics where they have established care, they can ask their primary care provider for help. They don’t need a referral to a specialist,” said Dr. Leigh Perreault, an endocrinologist at UCHealth and associate clinical professor at the University of Colorado School of Medicine. “It’s good for patients to know if they want medical assistance with their weight, they can now get it at UCHealth with their regular provider at no additional cost,” she said.
A key element of the approach is the “weight-prioritized visit.”
When a patient goes into a UCHealth primary care office, the patient might see a small sign at the check-in desk that says, “Would you like medical assistance with your weight? If so, please schedule a weight-prioritized visit with your provider.”
If the patient schedules this special visit, it’s a sign that the patient wants to talk about weight concerns. It’s also an indicator to the provider that this visit is going to be a safe space to focus solely on the weight issue. Both parties understand this clear purpose and eliminate the uncomfortable feelings or embarrassment that may be connected with discussing obesity or losing weight.
A specially designed interface on the Epic electronic health record helps drive the conversation during the visits and filters what tools – or treatment options – might be most appropriate for the patient, from nutrition counseling to weight loss medications to behavioral change support to bariatric surgery. Then, just like a patient with another chronic disease would return for continued care, the PATHWEIGH process encourages follow-up weight-prioritized visits.
“The benefit of providing this care in the primary care clinics is the long-term relationship with the patients and their providers,” said Dr. Pete Smith, UCHealth’s medical director for primary care and assistant dean for clinical affairs at the University of Colorado School of Medicine. “Weight loss and weight loss maintenance is a lifelong commitment. You really need to be invested in the lifelong relationship. And that’s what primary care providers do.”
A pilot study of the PATHWEIGH approach showed that integrating weight loss into primary care can help patients not only lose approximately three times the weight as other patients but also address the more than 200 health problems that often come with obesity, including metabolic problems (diabetes, hypertension, heart disease), 50% of all cancers, mental health problems and orthopedic issues that may require knee, hip or other joint replacements. These impressive results were the impetus to integrate PATHWEIGH into 66 of UCHealth’s primary care clinics across Colorado and Wyoming.
The rollout comes at a time when approximately 73% of U.S. adults have a body mass index 25 kg/m2 or more, indicating they are at the very least overweight, and 43% have a body mass index of 30 kg/m2 or more, indicating that they have obesity, according to a 2020 U.S. Centers for Disease Control and Prevention estimate. By 2030, the CDC projects that 50% of U.S. adults will have obesity.
It also comes at a time when there are more tools and options than ever that are very effective at managing obesity. “Everyone who has worked on this should be so proud,” Perreault said. “This will be the beginning of something utterly transformative for weight management for patients across Colorado, the U.S., and maybe even around the world.”
PATHWEIGH is available to patients at UCHealth primary care clinics in Colorado and Wyoming. Patients can call their UCHealth primary care clinic to learn more about the approach or schedule a weight-prioritized visit. It is not available in non-UCHealth clinics at this time.
UCHealth is an innovative, nonprofit health system that delivers the highest quality medical care with an excellent patient experience. UCHealth includes 30,000 employees, 12 acute-care hospitals and hundreds of physicians across Colorado, southern Wyoming and western Nebraska. With University of Colorado Hospital on the CU Anschutz Medical Campus as its academic anchor and the only adult academic medical center in the region, UCHealth is dedicated to providing unmatched patient care in the Rocky Mountain West. Offering more than 150 clinic locations, UCHealth provides extensive community benefits and pushes the boundaries of medicine through advanced treatments and clinical trials, improving health through innovation.