Background

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.

Methods

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.

Results

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.

Conclusions

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.