Managing obesity in primary care practice: an overview with perspective from the POWER-UP study

Area of Science:

• Obesity management in primary care
• Behavioral weight loss interventions
• Clinical trial research

Background:

• Primary care practitioners (PCPs) are encouraged to screen for obesity and provide weight loss counseling.
• Limited research exists on effective obesity intervention delivery within primary care.
• The National Heart, Lung, and Blood Institute initiated the POWER trials to address this gap.

Purpose of the Study:

• To review prior randomized controlled trials on obesity management.
• To detail the rationale, methods, and results of the POWER-UP trial at the University of Pennsylvania.
• To compare findings across the three POWER trials (POWER-UP, Johns Hopkins, Harvard/Washington).

Main Methods:

• Review of pre-POWER randomized controlled trials.
• Detailed description of the POWER-UP trial methodology.
• Comparison of diverse behavioral weight loss counseling delivery methods across POWER trials.

Main Results:

• The POWER trials utilized varied approaches for behavioral weight loss counseling.
• Delivery methods ranged from in-practice counseling by medical assistants and PCPs to external call centers and websites.
• Findings from POWER-UP were compared to other POWER trial results.

Conclusions:

• Different methods for delivering behavioral weight loss counseling were tested in primary care.
• The efficacy of primary care-based weight loss interventions should consider cost-effectiveness.
• The study highlights the need for guidance on implementing obesity interventions in routine clinical practice.