Background

Obesity is a major health problem in the United States and weight loss is associated with significant clinical benefits. The Cleveland Clinic Integrated Weight Management Program is an intensive lifestyle program based on monthly shared medical appointments (SMA) with emphasis on nutrition, physical activity, appetite control, sleep disorders, and stress management.

Methods

A retrospective chart review of Cleveland Clinic Endocrinology SMA participants from January 1, 2015 to May 31, 2017 was performed. Pertinent categorical and continuous variables of the population enrolled in the SMA were summarized and compared between a control group (attended only 1 SMA) vs patients who attended > 1 SMA in 1-year.

Results

A total of 335 patients were included and baseline characteristics were compared (SMA vs control). Average age was 51.3 vs 47.6 years (p 0.07).The majority of patients were female (83.4%) and Caucasian (51.2%)Baseline weight (kg) was 116.2 vs 130 (p 0.002) and BMI 42.5 vs 46.1 (p 0.02). Active prescription of FDA approved AOM within 1-yr of SMA enrollment was 37.4% vs 19.6% (p 0.02). Phentermine was used in 33.6% vs 10.9% (p 0.002), phentermine-topiramate 5.2% vs 2.2% (p 0.37), buproprion-naltrexone 7.43% vs 4.4% (p 0.47). Average weight change (%) at 1-year was -6.2 ± 7.3 in the SMA group vs. 2.4 ± 4.7 in the control group. After controlling for potential confounders, SMAs remained associated with increased weight loss (%) at 12-months.The average number of SMAs attended in the SMA group was 5.7 in 1-year. Completers (did not miss ≥ 3 consecutive SMA within 1-year) showed more robust weight loss results when compared to dropouts (-8.4 ± 7.4 vs -4.1 ± 6.5 p< 0.0001).

Conclusions

SMAs were associated with greater weight loss at all-time points when compared to the control group. Obesity is a chronic disease that should be treated in the medical setting, and SMAs appear to be a potential tool to help practitioners deliver an effective treatment of obesity.