Losing weight is not easy. While we all understand the basics of shedding pounds, it’s the sticking to it that tends to be the hard part.
Now Wayne Altman, Jaharis Chair of Family Medicine at Tufts School of Medicine, has shown that there is a better way: using group meetings focused on wellness and weight loss.
Altman has been providing his patients with help in the form of wellness group meetings since 2009. Recently, he led a study comparing behavioral changes and weight loss for patients with obesity who took part in weekly group visits with patients who received traditional care—limited one-on-one visits with physicians. He and his colleagues found that the group participants were more likely to sustain healthy behaviors and lost more weight than those who received traditional care.
What accounts for the difference? “The two most important ingredients for weight-loss success are support and accountability, and that’s where wellness groups thrive,” Altman said. “The one-on-one visits with a physician are important, and an important relationship to establish, but the shared experiences and goals, camaraderie, and mentoring in the group meetings help push patients toward the finish line.”
In the study, the group visits were co-led by a physician and a dietician; the groups were made up of six to 15 patients who met 15 times over the course of 20 weeks. All the participants were adults, mostly between ages 40 and 60, with obesity (a body-mass index more than 30) and were referred by a physician. They also were motivated: they shared the goals of losing weight and learning and adopting healthy lifestyle habits.
Patients who took part in group visits lost an average of 17 pounds, with 61 percent losing at least 5 percent of their initial body weight. Of those who lost at least 5 percent of their weight, 69 percent kept it off for at least one year after the group meetings ended. The wellness group patients lost an average of 15 pounds more than those in the traditional care group after a year, and decreased their BMI by an average of 2.5 more points than those not in groups.
The results were published in a study in the Journal of the American Board of Family Medicine on November 27. The first author on the study is Karen Axten, M16, who worked on the study while a medical student at Tufts.
Altman brings about 20 Tufts medical students into his private practice based in Arlington, Massachusetts, each year, and has third-year students take part in the wellness group sessions. Students experience the group visit model, take patient notes, and sometimes help with counseling or share their own stories.
Altman, who became the chair of family medicine in July 2017, hopes to create a research division within the department in order to highlight faculty studies in health-care costs and quality. “A family physician is an advocate for the patient in the complex health system,” he said. “The group visit model provides patients with not only a support system but also more time with a physician—and the physician can spend more time with more patients. Innovative health-care delivery models that generate higher quality at lower costs—and group visits are one such model—should be studied and published about.”
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