Breaking Barriers in Obesity Care - Scaling a Primary Care Weight Management Program Statewide

Obesity disproportionally impacts North Carolina, with rates exceeding national obesity rates, especially in rural areas. Lack of access to obesity care has been identified as a barrier to treatment nationally, excessively impacting those most vulnerable to the risks and consequences of obesity. UNC Health piloted a primary care-based weight management program in 2019, and this article details the program's subsequent scaling across a statewide footprint to address the problem for both adult and pediatric populations. The program leverages American Board of Obesity Medicine specialty-certified primary care clinicians. It focuses on brief nutritional counseling and prescription of both first-generation anti-obesity medications and glucagon-like peptide-1 medications. Between 2019 and 2025 the program successfully scaled across North Carolina, growing from 3 physicians in 3 counties in 2019 to 17 clinicians in 9 counties in 2025, with each providing a half to a full day per week of their clinical time purely dedicated to weight management. Between these dedicated clinic sessions and weight management patients seen during their usual primary care sessions, the physicians cumulatively cared for more than 3000 patients. While scaling across a broad statewide footprint, the program has continued to deliver clinical success while being financially sustainable for the health system. More than one half of patients who attend at least four visits achieve 5% weight loss, and more than one third achieve 10% weight loss. This program successfully eliminates barriers and provides effective, accessible, and evidence-based weight management care to patients disproportionately impacted by the obesity epidemic.