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Observational Study
. 2020 Dec;28(12):2305-2309.
doi: 10.1002/oby.22954. Epub 2020 Oct 7.

Diagnosing Obesity as a First Step to Weight Loss: An Observational Study

Elizabeth L Ciemins  1 , Vaishali Joshi  1 , John K Cuddeback  1 , Robert F Kushner  2 , Deborah B Horn  3   4 , W Timothy Garvey  5   6
Affiliations
Observational Study

Diagnosing Obesity as a First Step to Weight Loss: An Observational Study

Elizabeth L Ciemins et al. Obesity (Silver Spring). 2020 Dec.

Abstract

Objective: This study aimed to explore the relationship between an obesity diagnosis and weight loss as a percentage of total body weight loss over 9 to 15 months, using electronic health record data.

Methods: An observational study of 688,878 adult patients at 15 health systems with BMI ≥ 30 kg/m2 examined the relationship between weight loss and documentation of obesity diagnosis. Multivariable logistic regression models were created using a stepwise backwards elimination procedure to identify potential predictors of weight loss.

Results: Of patients with BMI ≥ 30, 44.9% had an obesity diagnosis on a claim or electronic health record problem list; 16.9% and 5.9% lost ≥ 5% and ≥ 10% of their body weight, respectively. Multivariable logistic regression models revealed a diagnosis of obesity on the same day as the initial weight (odds ratio [OR] = 1.3; CI: 1.2-1.3; P < 0.001) as a predictor of ≥ 5% total body weight loss in 9 to 15 months. Other significant predictors included an antiobesity medication prescription, female sex, diagnosis of type 2 diabetes, Medicare/Medicaid insurance, and number of ambulatory visits.

Conclusions: While controlling for potentially confounding factors, documentation of an obesity diagnosis remained independently predictive of at least 5% weight loss. This suggests that documenting a diagnosis of obesity may be an important step toward engaging patients to lose weight.

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Conflict of interest statement

ELC, VJ, and JKC are employees of AMGA and declared no conflict of interest. RFK has received research grant support from Novo Nordisk and is on its Global and National Advisory Board. DBH is a consultant with Bausch Health, Novo Nordisk, and Medtronic and received research funding from Novo Nordisk. WTG received research funding through his academic institution from Novo Nordisk, Sanofi, Lexicon, and Pfizer and received honoraria as advisory board member for Novo Nordisk, BOYDSense, Gilead, Boehringer‐Ingelheim, and Amgen.

Figures

Figure 1
Figure 1
Weight loss by obesity diagnosis on same day as initial weight. Compares weight loss of ≥ 5% and ≥ 10% body weight among individuals with and without an obesity diagnosis on a claim or patient problem list on the same day as an initial weight. Individuals who lost ≥ 10% are included in those who lost ≥ 5%. Both comparisons are statistically significant at P < 0.0001. Dx, diagnosis.
Figure 2
Figure 2
Predictors of ≥ 5% and ≥ 10% weight loss among primary care patients at 15 US health care organizations. Results are among adult patients with weights recorded at two ambulatory visits 9‐15 months apart. Dx, diagnosis.
See this image and copyright information in PMC

Comment in

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