Background

Little is known about characteristics and outcomes for patients in obesity medicine (OM) practices. OM providers rarely practice in safety-net systems. This project compares patients with and without diabetes (DM) seen in an obesity medicine practice in a safety-net system between 2005 and 2019.

Methods

Electronic medical record (EMR) data were reviewed for patients attending the OM clinic. Demographic, clinical, and diagnostic data were compared at baseline for patients.Weight loss and attendance between groups were compared.Changes in metabolic measures were assessed. Between group comparisons of continuous variables were conducted using the Kruskal-Wallis Test. Comparing observed frequencies of categorical variables with what we would expect for groups were conducted using the chi-square test.

Results

Between 2005-2019 in the OM practice, 9610 patients attended one visit or more, 6,221 (65%) did not have DM, and 3,389 (35%) had DM.Patients who had bariatric surgery were excluded from the analysis. Compared to patients without DM, patients with DM had: higher in BMI (49 vs 43); higher Hemoglobin A1c (HbA1c) (7.4% vs 5.6%); and were more likely male (26% vs 16%); similar ethnically (47% vs 45%) African American (AA); older (49 vs 43 years); more likely on Medicare (15% vs 9%). Overall attendance: 43% attended one visit; 25% attended 2-3 visits; 32%> 3 visits. Attendance for > 1 year in OM practice was higher in patients with DM (38%vs 33%).After a year weight loss was similar (4.1% vs 4.4%). as was the proportion who lost weight (57%). Medicaid/no insurance and AA ethnicity predicted slightly less weight loss and follow-up. Initial assessment shows improvements in blood pressure and HbA1c.

Conclusions

Economically and ethnically diverse patients attending an OM practice in a safety-net system, improved weight and cardio-metabolic measures. Analysis are underway assessing the relationships between characteristics,treatments. and attendance, weight loss, and co-morbid outcomes.