The Be Fit, Be Well weight loss study was conducted in Boston by investigators from Washington University, Harvard School of Public Health, and Kaiser Permanente Colorado.
This study recruited participants from three Boston area community health centers: participants were predominantly low-income (>85%) and from racial/ethnic minority groups (>90%).
Participants were randomized to one of two arms: the Usual Care group received NHLBI's "Aim for Healthy Weight" brochure and continued their medical care as usual.
Participants in the Intervention group were assigned a health coach who provided support through 18 counseling phone calls and participants could also attend 12 bi-monthly group sessions led by trained study staff.
The health coach was a community health worker who was hired specifically for the research study and trained to deliver the intervention.
Participants set behavior change goals, self-monitored their progress, and received skill training using either a website, or a combination of telephone-based interactive voice response system and print materials.
Additionally, participants received tailored "prescriptions" for weight-related behavior changes signed by their provider, as well as tailored action plans to increase the use of community resources.
Key results: The recruitment and intervention costs for the two-year program were about $2,359 per participant. For the control intervention, the cost was $2,204 /kg of kilogram lost. The cost for a drop in blood pressure was $621 /mmHg.
However, analysis suggests that the cost can be lower if providers make minor adjustments and increase the sample size.
Conclusions: Be Fit Be Well program was expensive to implement compared to other weight loss products. It was also excessively higher than what Medicaid and the Centers for Medicare reimburse medical doctors for obesity counseling.
However, multimorbid and socioeconomically disadvantaged obese patients face serious and more costly consequences if they do not get help. Therefore, the resources used in the study are still cost-effective over the long-term.
But for patients that can access alternative commercial weight loss medication, they do not need these more expensive weight loss approach.
Bennett, GG, Warner, ET, Glasgow, RE, Askew, S, Goldman, J, Ritzwoller, DP, Emmons, KM, Rosner, BA, Colditz, GA for the Be Fit, Be Well Study Investigators. (2012). Obesity Treatment for Socioeconomically Disadvantaged Patients in Primary Care Practice. Arch Intern Med. doi:10.1001/archinternmed.2012.1