Where do patients obtain obesity care? Understanding the Sources and Programs

When it comes to seeking obesity care, many patients turn to sources that are not evidence-based, such as books, YouTube videos, internet advertising, and infomercials. The prevalent use of search engines like Google further shapes the information patients receive, often prioritizing commercial items that are not grounded in scientific evidence. For example, searching for weight loss often yields results focused on selling products rather than providing evidence-based guidance. Moreover, visual content like before and after pictures dominates the narrative, highlighting outcomes rather than the hard work involved in the journey.

Despite the overwhelming influence of non-evidence-based sources, there are several evidence-based programs available in the weight management industry. One well-known program is Weight Watchers, which has transitioned from a points-based system to diet-based options and boasts positive results. Similarly, Jenny Craig offers frozen meals at a higher cost, while Nutrisystem provides dry and frozen foods accompanied by counseling services. Other programs like HMR and WonderSlim offer total meal replacement and medical oversight, albeit at higher costs. Optifast is another program worth considering.

In the digital realm, Noom has gained significant revenue and a high success rate among users, utilizing a monthly subscription model. GOLO, on the other hand, emphasizes nutrient-rich foods but tends to promote their own costly supplements, which may limit its accessibility. Omada Health offers a counseling approach through digital platforms and caters to individuals with health problems. Virta Health targets employers and insurers, raising substantial funds annually.

Other medically-based commercial programs include Calibrate, which employs a virtual coaching system with medical oversight and utilizes GLP1 medications. Found, priced at $149 per month, combines health coaching with the use of generic off-label and branded medications, helping patients navigate insurance coverage. Additionally, Intellihealth provides a platform for healthcare providers and patients to communicate via a dedicated app.

Numerous other programs and apps exist, such as ediets, Atkins, SlimFast, Fitbit, MyFitnessPal, and Apple Watch, although their effectiveness may vary. Notably, one company attempted to tailor diets to individuals' genes but did not achieve significant weight loss, highlighting the need for more research and evidence-based approaches.

Given that over 42 percent of the US population is classified as obese and 9 percent as extremely obese, engaging with commercial programs becomes crucial. Many companies are now implementing programs to assist their employees, with initiatives like Wondr and Real Appeal. For instance, Real Appeal signed on 96 companies, and participants attending counseling sessions experienced an average weight loss of 2.8%. These programs also demonstrated reductions in insurance claims, making them financially worthwhile.

In terms of medical management, primary care plays a crucial role. While certified obesity specialists are making progress, there remains a knowledge gap among healthcare providers. For example, only 16 percent were aware of the indications for obesity pharmacotherapy, and just 25 percent knew that obesity medications could be prescribed beyond three months. Time constraints and assumptions about patient motivation often hinder healthcare providers' ability to address obesity care comprehensively.

Although 72 percent of healthcare providers feel responsible for helping their patients, employers are often the least involved, providing healthcare benefits without weight management options. The uncertain reimbursement landscape, coding and diagnostic challenges, and issues with prescribing and prior authorization further complicate the delivery of obesity care. Therefore, better physician training, value-based care models, data sharing, and incentives from health insurance providers are crucial factors in overcoming these barriers.

In terms of obesity competency, it is imperative that all healthcare providers receive training in obesity care, along with the establishment of standardized care protocols. Relevant standards can be found in the Journal of Obesity. Additionally, healthcare providers need effective tools that work, such as the use of medications such as semaglutide and tirzepatide, which have shown to cause weight loss of more than 15%. These medications hold promise for not only weight management but also in addressing cardiovascular health and conditions like non-alcoholic steatohepatitis (NASH). As the landscape of obesity care continues to evolve, it is essential to engage stakeholders from the private sector, public health, educational institutions, and patient advocacy groups.

To improve obesity care, there is a need for collaborative efforts and data sharing. By engaging the private sector, innovative solutions can be developed, and partnerships can be forged to enhance access to evidence-based programs. Public health initiatives should focus on raising awareness, promoting healthy lifestyles, and addressing social determinants of health that contribute to obesity. Educational institutions have a critical role in training healthcare providers in obesity care and ensuring that standards of care are met across the board.

It is crucial to recognize that obesity is a complex medical condition that requires a multidimensional approach. Effective obesity care should involve not only weight management but also address associated comorbidities, psychological factors, and lifestyle modifications. Patient advocacy groups can play a significant role in driving policy changes, raising awareness, and reducing weight bias and stigma associated with obesity.

In conclusion, while patients often turn to non-evidence-based sources for obesity care, there are evidence-based programs available in the weight management industry. By engaging in collaborative efforts, improving physician training, implementing value-based care models, and fostering partnerships across various sectors, we can bridge the gap between evidence-based care and the needs of patients with obesity. With a comprehensive and patient-centered approach, we can strive to improve outcomes, reduce the burden of obesity, and promote overall health and well-being.