Impact of a Novel Wellness Group Visit Model on Obesity and Behavior Change.

BACKGROUND

Increasing weight-related illness in the United States has led to 120,000 preventable deaths annually and soaring medical costs. Treating patients in a group setting may be more effective than traditional care (TC) in achieving behavioral change. We studied a wellness-group (WG) model to determine whether it could generate sustained behavioral change and weight loss in a subset of patients.

METHODS

99 patients with a body mass index (BMI) >30 kg/m2 from 1 family practice volunteered to participate in a 15-visit WG co-led by a family physician and dietitian. We compared these WG patients with 190 patients who had a BMI >30 kg/m2 and who received TC in the form of an annual physical during the same time period. The patients were mostly white, highly educated, and of middle-to-high-income households. All patients were surveyed on their ability to sustain 12 wellness behaviors 3 months after completing their WG or physical. Patients were not paid to complete the survey. We reviewed medical charts for weight, BMI, blood pressure, lipids, and glycohemoglobin before and at least 1 year after the WG or physical. WG patients' weights were recorded at the beginning and end of the WG as was the weight from their most recent office visit.

RESULTS

WG patients were more likely to report sustaining 12 of 12 wellness behaviors than patients who received TC with an annual physical. At 1 year, WG patients also lost more weight than TC patients (-13.21 pounds for WG vs +1.94 pounds for TC) and achieved greater reduction in their systolic blood pressure (-6.96 mm Hg for WG vs -1.13 mm Hg for TC). Average weight gained after the WG was 6.9 pounds. Among WG patients, 61% lost a clinically relevant amount of weight (>5%). Of the WG patients who lost clinically relevant weight, 71% were able to maintain at least half of their weight loss 3 years later.

CONCLUSIONS

An observational study of a novel WG model showed that WG patients sustained wellness behaviors and weight loss over time when compared with patients who received TC.