A new study in the journal Family Practice shows that intensive behavioral therapy from dietitians may be a very effective ways for older Americans to lose weight.
Some 39.8% of the general adult population is obese. The economic consequences of obesity are high, with estimated $1,429 greater annual healthcare expenditures per obese person and $147 billion overall per year. Obesity is also associated with increased risk of type 2 diabetes, stroke, certain cancers, and cardiovascular disease.
The primary objectives of this study were to examine the integration of registered dietitian nutritionist-provided intensive behavioral therapy for obesity into a primary care setting and evaluate clinic outcomes for Medicare patients.
Patients undergoing intensive behavioral therapy for obesity met with a registered dietitian once every week for the first month, and once every other week for the next six months, and then (if the patient lost weight) once a month for an additional six months to discuss challenges and lifestyle changes. The patients and the dietitians discussed behavioral health risks and factors affecting their choices. The dietitians recommended clear, specific, and personalized advice and the dietitians and the patients worked together to pick goals and methods to achieve them, and the two arranged follow up meetings to discuss progress and challenges.
This study was a retrospective chart review of therapy sessions conducted at a rural family medicine clinic in eastern North Carolina for patients between 2016 and 2019. Patients were female, had Medicare insurance, and a Body Mass Index above 30. A total of 2,097 female patients met the criteria for eligibility for the therapy.
Analysis showed statistically significant improvements in clinical outcomes from intensive behavioral therapy treatment. Patients in the treatment group lost, on average, 2.66 lbs, roughly 1.22 lbs per intensive behavioral therapy visit, compared to patients in the control group who gained an average of 0.5 lbs. Body Mass Index and A1C (average blood sugar) declined for intensive behavioral therapy patients. Patients also took prescription medication an average of six days less than the control group.
This study suggests that the advantages of dietitian-provided intensive behavioral therapy extend beyond weight loss to include associated benefits for Medicare patients. The researchers involved in the study believe that the results indicate it may be time for primary care physicians to expand their use of dietitians given their proven effectiveness.
"We are excited about our findings, which demonstrated registered dietitian nutritionist delivered intensive behavioral therapy for obesity to Medicare beneficiaries is effective and beneficial for patients," said Lauren Sastre, one of the paper's authors. "This particularly important in light of the growing pressure on providers to track and demonstrate improved Medicare patient outcomes, which include weight status."
Direct correspondence to:
Department of Nutrition Science
East Carolina University
Greenville, NC 27858
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