One‐Year Results of the Think Health! Study of Weight Management in Primary Care Practices
Abstract
The Think Health! study evaluated a behavioral weight loss program adapted from the Diabetes Prevention Program (DPP) lifestyle intervention to assist primary care providers (PCPs) and auxiliary staff acting as lifestyle coaches (LCs) in offering weight loss counseling to their patients. In a randomized trial conducted at five clinical sites, study participants were randomly assigned in a 1:1 ratio within each site to either “Basic Plus” (n= 137), which offered PCP counseling every 4 months plus monthly LC visits during the first year of treatment, or “Basic” (n= 124), which offered only PCP counseling every 4 months. Participants were primarily (84%) female, 65% African American, 16% Hispanic American, and 19% white. In the 72% of participants in each treatment group with a 12‐month weight measurement, mean (95% CI) 1‐year weight changes (kg) were −1.61 (−2.68, −0.53) in Basic Plus and −0.62 (−1.45, 0.20) in Basic (difference: 0.98 (−0.36, 2.33);P= 0.15). Results were similar in model‐based estimates using all available weight data for randomized participants, adjusting for potential confounders. More Basic Plus (22.5%) than Basic (10.2%) participants lost ≥5% of their baseline weight (P= 0.022). In a descriptive, nonrandomized analysis that also considered incomplete visit attendance, mean weight change was −3.3 kg in Basic Plus participants who attended ≥5 LC visits vs. + 0.53 kg in those attending <5 LC visits. We conclude that the Basic Plus approach of moderate‐intensity counseling by PCPs and their staff can facilitate modest weight loss, with clinically significant weight loss in high program attenders.
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Long-term weight loss in the enhanced lifestyle counseling group and in the brief lifestyle counseling group was greater than weight loss observed in other primary care trials, with the exception of a study involving extremely obese patients treated with intensive group lifestyle modification and weight-loss medications.
“Long-term weight loss in the group that received enhanced lifestyle counseling (as well as in the group that received brief lifestyle counseling without enhancement) was greater than weight loss observed in other primary care trials,5–7,30,31 with the exception of a study involving extremely obese patients who were treated with intensive group lifestyle modification and weight-loss medications.32”
From A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice (2011) · cites this paper as [31]
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A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice
Wadden, T. A., Volger, S., Sarwer, D. B., Vetter, M. L., Tsai, A. G., Berkowitz, R. I., Kumanyika, S., Schmitz, K. H., Diewald, L. K., Barg, R., et al. (2011) · New England Journal of Medicine · doi:10.1056/nejmoa1109220 · Cited by 487 · see citing works
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- Authors
- Kumanyika, S. K., Fassbender, J. E., Sarwer, D. B., Phipps, E., Allison, K. C., Localio, R., Morales, K. H., Wesby, L., Harralson, T., Kessler, R., Tan‐Torres, S., Han, X., Tsai, A. G., & Wadden, T. A.
- Affiliations
- University of Pennsylvania (US)
- Children's Hospital of Philadelphia (US)
- Einstein Healthcare Network (US)
- Corresponding author
- Kumanyika, Shiriki K.
- ORCID
- Venue
- Obesity
- Publisher
- Wiley
- Published
- 2012-06
- Volume
- 20
- Issue
- 6
- Pages
- 1249-1257
- ISSN
- 1930-7381 (ISSN-L)
- 1930-739X
- OpenAlex
- W2146059675
- Cited by
- 64
- References
- 10
- Citations by year
- 2026: 1 · 2025: 1 · 2023: 1 · 2022: 4 · 2021: 2 · 2020: 5 · 2019: 1 · 2018: 6 · 2017: 11 · 2016: 5 · 2015: 6 · 2014: 10 · 2013: 9 · 2012: 1
- FWCI
- 15.85
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Obesity (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University of Pennsylvania
- National Institutes of Health (5p60md000209-05)
- National Institute of Child Health and Human Development
- National Center on Minority Health and Health Disparities
- National Institute on Minority Health and Health Disparities (P60 MD000209-05)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (K12HD043459)
- Topics
- Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- weight management, weight loss counseling, lifestyle coaching, primary care, behavioral weight loss program, weight loss outcomes, program attendance
- MeSH terms
- Behavior Therapy, Black or African American, Female, Hispanic or Latino, Humans, Male, Middle Aged, Obesity, Patient Education as Topic, Pennsylvania, Primary Health Care, Philadelphia, Weight Loss, Exercise, Risk Reduction Behavior, White People, Weight Reduction Programs
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