PATHWEIGH: A new Approach to Weight Management in Primary Care
For years, endocrinologist Leigh Perreault, MD, felt frustrated with the standard approach to weight management – often leaving patients with advice to simply “eat better and exercise more,” even when it wasn’t enough. This led her to seek a more effective solution, ultimately creating PATHWEIGH, a structured process transforming weight care in primary care settings.
The Problem with Traditional Weight Management
Dr. Perreault observed that many medications prescribed addressed the symptoms of weight-related issues, rather than the root cause.She noted, “None of these people want to be on these medications… if I could just help them with their weight, many of these health concerns would probably go away.” This realization sparked a mission to develop a system focusing directly on weight management.
Introducing PATHWEIGH: A Structured System for Weight Care
PATHWEIGH is a structured process designed to help both patients and primary care teams focus on weight management. It introduces dedicated clinic visits specifically for weight-related care, rather than squeezing it into standard appointments. Funded by the National Institutes of Health (NIH), PATHWEIGH was initially rolled out across UCHealth’s 56 primary care clinics in Colorado, becoming one of the largest randomized trials in the field.
Key Findings & Results
- Reduced Weight Gain: The program reduced population weight gain by 0.58 kg over 18 months.
- Shifted trend: PATHWEIGH shifted the overall trend from steady weight gain to weight loss, a significant public health outcome.
- Increased Access to Care: Participation increased the likelihood of receiving weight-related care by 23%.
- Eliminated Population Weight Gain: PATHWEIGH successfully eliminated population weight gain across all UCHealth primary care clinics.
These results are positioning PATHWEIGH as a potential new standard of care, with several health systems nationwide exploring its adoption.
How PATHWEIGH Works: Building a Clear Path
Dr. Perreault describes PATHWEIGH as a way to align patients and clinicians towards a shared plan. “We built a highway that we could put all the vehicles on, so there’s actually a process for people to receive weight related care if they wanted it.”
Streamlined Process
- Accessibility: Clinics posted signs informing patients they could request a dedicated weight management appointment.
- Efficient Workflow: A request activated a process in the electronic health record, reducing time spent gathering basic facts.
- Consolidated Information: A survey completed by patients flowed directly into clinician notes, presenting a “menu” of potential interventions.
Addressing Barriers and Improving Conversations
Data from the 18-month trial showed that approximately one in four eligible patients received some form of weight-related care. Treatment was customized to each patient, and the program also addressed the discomfort often associated with discussing weight in medical settings.
“Most people who want or need weight related care never get it… This was a safe space to say, ‘Hey, if you would like medical assistance with your weight, we actually have a process for you to receive that now.’” – Leigh Perreault, MD
The Impact of Small Changes at Scale
Experts estimate that the obesity epidemic is driven by an average population weight gain of 0.5kg per year. PATHWEIGH’s ability to stop – and even reverse – this trend, even by a small margin, has significant implications for public health. Researchers also found that even patients who didn’t receive direct interventions experienced reduced weight gain compared to expected norms.
Future of PATHWEIGH: Expanding Access
The success of PATHWEIGH is driving expansion efforts. Plans are underway to extend the program beyond Colorado, and it’s being highlighted by the Obesity Association as a recommended care process.Five health systems across seven states are currently considering adoption, and the creators are working towards licensing the model.
“I’m really proud that PATHWEIGH was home-grown and built and tested here in Colorado,” says Perreault. “This is the blueprint that moves us forward.”
