Introduction & Objective: The current one-on-one management model for obesity in the ambulatory setting is suboptimal. Group visits have emerged as an effective alternative in other settings, such as in primary care and diabetes. However, data supporting the design and implementation of group visits for the long-term care of obesity is lacking.
Methods: We designed and implemented a multidisciplinary shared medical appointment (SMA) program for individuals with overweight/obesity being seen in an endocrinology ambulatory clinic. The program is designed in three phases to have a visit with an Endocrinologist, Dietitian, and SMA group visits. Anti-obesity medications (AOMs) are discussed and prescribed in an individualized approach. Sessions entail a 1.5 hour dialogue about specific monthly topics with both group and individualized focused discussions with a hybrid attendance model (virtual/in person) ranging from 2-9 patients. The primary outcome was change in body weight from baseline to program-end. Patients with at least 30 days of follow-up data were included in the analysis.
Results: Between July 2022-December 2023, N=333 were enrolled with 85% having at least 30-days of follow-up. Mean ± SD body mass index (BMI) was 41 ± 9 kg/m2 and weight 250 ± 59 lbs, and 27% had diabetes. Medications prescribed included AOMs (77% GLP-1 or GLP-1/GIP RAs). Attendance at SMAs varied (63% of patients attended 1-3 SMAs, 24% attended 4-6, and 12% attended 7+ sessions). Most participants (72%) lost weight from baseline to program-end and 32% lost >5% body weight. Overall, participants benefited from the program with a decrease in BMI of 1.4 kg/m2 (95% CI [-1.0, -1.7], P<0.01) and body weight loss of 8 lbs (95% CI [-6, -10], P<0.01).
Conclusions: We successfully designed and implemented a comprehensive group care model for overweight/obesity which resulted in reduction in weight and BMI. The model was implemented in a real-world high-volume ambulatory endocrinology setting.
R. Gorodeski Baskin: None. B. Hatipoglu: Research Support; Tandem Diabetes Care, Inc. I. Neeland: Speaker's Bureau; Boehringer-Ingelheim. Consultant; Eli Lilly and Company. Advisory Panel; Novo Nordisk A/S. Speaker's Bureau; Bayer Inc. Consultant; Nestlé Health Science. N.J. Bellini: Speaker's Bureau; Abbott. Advisory Panel; Medtronic. Speaker's Bureau; Sanofi. Consultant; embecta. Speaker's Bureau; MannKind Corporation. Advisory Panel; LifeScan Diabetes Institute. Consultant; Insulet Corporation. J.E. Blanchette: Speaker's Bureau; Insulet Corporation. Board Member; Juvenile Diabetes Research Foundation (JDRF). Research Support; American Heart Association, Association of Diabetes Care & Education Specialists, National Institute of Diabetes and Digestive and Kidney Diseases, Leona M. and Harry B. Helmsley Charitable Trust. Advisory Panel; LifeScan Diabetes Institute. Consultant; WellDoc. Advisory Panel; Cardinal Health/Edgepark. J. Tribout: None. R.C. Katona: None. E. Gorodeski: Consultant; Boston Scientific Corporation. Other Relationship; Dynamed Plus.
