Skip to main content
SpringerLink
Log in

Clinical Research

Early weight loss outcomes from a newly established hospital-affiliated specialized obesity care delivery model in Central Florida

  • Article
  • Published:
International Journal of Obesity Submit manuscript

Abstract

Significance

We evaluated weight loss outcomes in a newly established hospital-affiliated, physician-directed multidisciplinary, and personalized obesity care model.

Methods

Fifty established patients in a specialized obesity medicine practice underwent intensive lifestyle intervention ±adjunctive pharmacotherapy (46/50) for >6 consecutive months and when required, psychological intervention. We identified demographics, obesity-related comorbidities, anthropometric changes over time, and laboratory screen. Psychosocial status was determined using Beck Depression Inventory-II (BDI-II), Brownell-Stunkard Weight-Loss Readiness Test, and Impact of Weight on Quality of Life-Lite (IWQOL).

Results

Patient characteristics (mean ± SD) were: 70% female; age 47.0 ± 16.4 y; weight 111.55 ± 32.8 kg; BMI 39.3 ± 8.8 kg/m2; % body fat 45.5 ± 6.3. Patients had attempted at least one diet prior to seeking tertiary obesity care and averaged 2.5 major co-morbidities. In regards to health status, 74% were insulin resistant [HOMA]; 12% had Type 2 DM (HbA1c > 6.5%); 46% were hypertensive; 48% had dyslipidemia, 38% were vitamin D deficient; 44% were depressed (BDI-II). Weight loss at 3 and 6 months averaged −4.18 and −7.88 kg and percentage changes in BMI a respective −4.39 and −7.74% (p < 0.0001). Forty percentage were early responders (ER), having lost ≥ 5% of their initial weight 3 months into the program. Total weight loss for ER vs. non-responders (NR) at 3 months was −7.90 and −1.71 kg, respectively (p < 0.0001) and mean % BMI changes from baseline were a respective −7.77 and −1.88%.

Conclusions

Organized hospital-affiliated specialized obesity care delivery models can be successful in personalized obesity treatment. These types of medical programs for complicated obesity are likely to reduce impediments to addressing obesity effectively.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Baum C, Andino K, Wittbrodt E, Stewart S, Szymanski K, Turpin R. The challenges and opportunities associated with reimbursement for obesity pharmacotherapy in the USA. Pharmacoeconomics. 2015;33:643–53.

    Article  Google Scholar 

  2. Srivastava G, Apovian CM. Current pharmacotherapy for obesity. Nat Rev Endocrinol. 2017;14:12–24.

    Article  Google Scholar 

  3. Sebiany AM. Primary care physicians’ knowledge and perceived barriers in the management of overweight and obesity. J Fam Community Med. 2013;20:147–52.

    Article  Google Scholar 

  4. Bleich SN, Bandara S, Bennett WL, Cooper LA, Gudzune KA, U.S. health professionals’ views on obesity care, training, and self-efficacy. Am J Prev Med. 2015;48:411–8.

    Article  Google Scholar 

  5. Mauro M, Taylor V, Wharton S, Sharma AM. Barriers to obesity treatment. Eur J Intern Med. 2008;19:173–80.

    Article  Google Scholar 

  6. Glauser TA, Roepke N, Stevenin B, Dubois AM, Ahn SM. Physician knowledge about and perceptions of obesity management. Obes Res Clin Pract. 2015;9:573–83.

    Article  Google Scholar 

  7. Bennett GG, Steinberg DM, Pagoto SL. Will obesity treatment reimbursement benefit those at highest risk? Am J Med. 2015;128:670–1.

    Article  Google Scholar 

  8. Lee BY, Bartsch SM, Mui Y, Haidari LA, Spiker ML, Gittelsohn J. A systems approach to obesity. Nutr Rev. 2017;75(suppl 1):94–106.

    Article  Google Scholar 

  9. Wiebe JS, Penley JA. A psychometric comparison of the Beck Depression Inventory-II in English and Spanish. Psychol Assess. 2005;17:481–5.

    Article  Google Scholar 

  10. Carlson S, Sonnenberg LM, Cummings S. Dieting readiness test predicts completion in a short-term weight loss program. J Am Diet Assoc. 1994;94:552–4.

    Article  CAS  Google Scholar 

  11. Kolotkin RL, Head S, Hamilton M, Tse CK. Assessing impact of weight on quality of life. Obes Res. 1995;3:49–56.

    Article  CAS  Google Scholar 

  12. Unick JL, Pellegrini CA, Demos KE, Dorfman L. Initial weight loss response as an indicator for providing early rescue efforts to improve long-term treatment outcomes. Curr Diab Rep. 2017;17:69.

    Article  Google Scholar 

  13. Geha P, Cecchi G, Todd Constable R, Abdallah C, Small DM. Reorganization of brain connectivity in obesity. Hum Brain Mapp. 2017;38:1403–20.

    Article  Google Scholar 

  14. Jones A, Hardman CA, Lawrence N, Field M. Cognitive training as a potential treatment for overweight and obesity: a critical review of the evidence. Appetite. 2017;124:50–67.

    Article  Google Scholar 

  15. Garfinkel BP, Hotamisligil GS. ER stress promotes inflammation through re-wired macrophages in obesity. Mol Cell. 2017;66:731–3.

    Article  CAS  Google Scholar 

  16. Ellulu MS, Patimah I, Khaza’ai H, Rahmat A, Abed Y. Obesity and inflammation: the linking mechanism and the complications. Arch Med Sci. 2017;13:851–63.

    Article  CAS  Google Scholar 

  17. Asghar A, Sheikh N. Role of immune cells in obesity induced low grade inflammation and insulin resistance. Cell Immunol. 2017;315:18–26.

    Article  CAS  Google Scholar 

  18. Koch CE, Leinweber B, Drengberg BC, Blaum C, Oster H. Interaction between circadian rhythms and stress. Neurobiol Stress. 2017;6:57–67.

    Article  CAS  Google Scholar 

  19. Presson AP, Zhang C, Abtahi AM, Kean J, Hung M, Tyser AR. Psychometric properties of the Press Ganey(R) Outpatient Medical Practice Survey. Health Qual Life Outcomes. 2017;15:32.

    Article  Google Scholar 

  20. Spring B, Sohn MW, Locatelli SM, Hadi S, Kahwati L, Weaver FM. Individual, facility, and program factors affecting retention in a national weight management program. BMC Public Health. 2014;14:363.

    Article  Google Scholar 

  21. Hadziabdic MO, Mucalo I, Hrabac P, Matic T, Rahelic D, Bozikov V. Factors predictive of drop-out and weight loss success in weight management of obese patients. J Hum Nutr Diet. 2015;28(Suppl 2):24–32.

    Article  Google Scholar 

  22. Teixeira PJ, Going SB, Houtkooper LB, Cussler EC, Metcalfe LL, Blew RM, et al. Pretreatment predictors of attrition and successful weight management in women. Int J Obes Relat Metab Disord. 2004;28:1124–33.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

The authors would like to thank the exemplary, dedicated clinical team at COM including the clinical Lifestyle team that was co-founded with COM for administrative support. We thank Florida Hospital Medical Group for their keen business insights and the Translational Research Institute in Orlando, FL for mentorship and support in the establishment of an obesity clinical infrastructure. We would also like to thank Monica Reed, MD former CEO of Celebration Health, who was present during the implementation phase of COM and initial year, whose unrelenting support and understanding for a comprehensive wellness and obesity program brought COM to life. Finally, we are grateful to all of our patients suffering with obesity who found COM to be their medical home.

Author contributions

GS conceptualized and designed the clinical infrastructure for COM during the implementation phase. GS collected de-identified data, analyzed, and interpreted the results and wrote the content of the manuscript. CB gave valuable research insights when designing COM. CB provided critical statistical analyses and edited the content of the manuscript.

Funding

No funding was provided for this study. GS serves as a consultant for Johnson and Johnson. GS was the Founder of the Center for Obesity Medicine (COM).

Author information

Authors and Affiliations

  1. Department of Medicine, Section of Endocrinology, Diabetes, Nutrition and Weight Management, Boston University School of Medicine, Boston, MA, USA

    Gitanjali Srivastava

  2. The Center for Obesity Medicine, Florida Hospital Medical Group, Florida Hospital Celebration Health, Celebration, FL, 34747, USA

    Gitanjali Srivastava

  3. Florida Hospital Celebration Health, Celebration, FL, 34747, USA

    Gitanjali Srivastava & Cynthia Buffington

Authors
  1. Gitanjali Srivastava
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Cynthia Buffington
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gitanjali Srivastava.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Srivastava, G., Buffington, C. Early weight loss outcomes from a newly established hospital-affiliated specialized obesity care delivery model in Central Florida. Int J Obes 43, 132–138 (2019). https://doi.org/10.1038/s41366-018-0092-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41366-018-0092-3

  • Springer Nature Limited

Search

Navigation