Patients and Primary Care Providers face difficulties in knowledge, motivation, expectation, appropriate setting and affordability of services for an effective weight loss and maintenance program. It is difficult to provide a comprehensive weight management care with behavioral, nutritional, physical activity and pharmacological interventions from a small rural primary care office with one physician, two medical assistants without any dietitian, behavioral and physical therapist..A simple easy to follow, safe and cost effective DIY-WLP brought patients in the 'driver' seat for weight loss journey.The objective of this study was to evaluate the effects of the DIY- WLPin biometrics andcardiovascular risks.
Motivated patients with BMI more than 27.6 were selectedto participate in individualized WLP. Behavioral components were daily weight check and 3 meals/day. Nutritional components wereadequate water, low carbohydrate or low calorie and adequate protein diet. Physical activity goal was 150minutes /week or 10.000 steps /day. Pharmacological components include multivitamins, vitamin D, fish oil, Metformin, Topiramate. and Phentermine in selected patients The initial goal was a 5-10% weight loss in 3-6 months. Participants saw the physician monthly and support staff weekly/biweekly.
Weight loss data from 78 adults (average age 43) for 24 months (average 41 weeks) is presented. Average weight loss was 9.8% equal 24 pounds. 83% of patients lost more than 4.9% where as only 35.5% of CDC-DPP participants lost 5% body weight. Weight loss in all groups were associated with improvements in biometrics (BMI, waist circumference), lab values (HbA1c, total cholesterol, HDL, LDL), Framingham score and ACC-AHA risk scores, thus reducing overall cardiovascular risk.
In spite of limited resources in a rural primary care office, it is possible to offer effective WLP. Our DIY WLP shows an average 9.8% weight loss with improvement in biometrics and cardiovascular risk.