Daily Self-Weighing for Obesity Management in Primary Care

项目摘要/摘要 大多数患有肥胖症的成年人体重继续增加。虽然初级保健临床指南建议提供 肥胖症患者接受或转诊接受强化体重管理治疗，存在重大障碍 送到快递。即使提供，许多患者也没有时间或资源参与。有鉴于此，沿着 面对减肥和保持体重的挑战，一个专注于破坏的减害框架 初级保健肥胖患者中与年龄相关的持续体重增加可能是缓解肥胖的一种策略 肥胖对健康的不利影响。自我调节理论认为，日常自我称重(DSW；即指导 每天称体重并监测体重)为患有以下疾病的患者提供了一种简单的体重管理方法 肥胖。我们和其他人已经证明，DSW与更好的体重管理相关，并且可能是理想的 用于初级保健，因为其负担较低，并且与建议自我保健的临床指南一致 监测健康参数，如血压和血糖。然而，DSW在以下情况下的影响 在成人肥胖症患者中实施初级保健的情况尚不清楚。因此，我们建议进行SWOP (初级保健中肥胖管理的每日自称)，一项为期24个月的随机对照试验 (随机对照)400名肥胖成人(即体重指数：kg/m2≥30)通过 附属于阿拉巴马大学伯明翰分校(UAB)的临床网络。登记的参与者将收到 体重管理教育材料，然后随机到DSW或标准护理(SC)。DSW将 包括提供带有图形重量反馈的联网数字秤，而SC将涉及日常工作 关心。我们将测试分配给DSW对体重(主要结果)和自我启动的因果影响 在24个月内采用体重管理做法(次要结果)(目标1)。我们还将测试 坚持DSW对体重和体重控制实践的因果影响(目标2)。最后，我们将评估 DSW与SC的成本效益比较(目标3)。结果将使我们能够估计DSW是否缓解 肥胖成人中与年龄相关的体重持续增加。如果是这样的话，DSW可能会有实质性的公共卫生 并通过提供一种在初级保健中可行的体重管理策略来实现经济效果。

PROJECT SUMMARY/ABSTRACT Most adults with obesity continue to gain weight. While primary care clinical guidelines recommend provision of, or referral to, intensive weight management treatment for patients with obesity, there are significant barriers to delivery. Even if offered, many patients do not have the time or resources to participate. Given this, along with the challenges of losing weight and keeping it off, a harm reduction framework focused on disrupting continued age-related weight gain among primary care patients with obesity may be a strategy to mitigate obesity's adverse health effects. Self-regulation theory suggests that daily self-weighing (DSW; i.e., instruction to weigh daily and monitor weight) offers a simple way to promote weight management among patients with obesity. We, and others, have shown that DSW associates with better weight management and may be ideal for primary care because of its low-burden and consistency with clinical guidelines recommending self- monitoring of health parameters such as blood pressure and glucose. However, DSW's effect when implemented in primary care among adults with obesity is unknown. Therefore, we propose conducting SWOP (Daily Self-Weighing for Obesity Management in Primary Care), a 24-month randomized controlled trial (RCT) in 400 adults with obesity (i.e., body mass index [BMI]: kg/m2 ≥30) receiving primary care through a clinical network affiliated with the University of Alabama at Birmingham (UAB). Enrolled participants will receive weight management educational materials and then randomized to DSW or standard care (SC). DSW will involve provision of a web-enabled digital scale with graphical weight feedback, while SC will involve routine care. We will test the causal effect of assignment to DSW on weight (primary outcome) and self-initiated adoption of weight management practices (secondary outcomes) over 24 months (Aim 1). We will also test the causal effect of DSW adherence on weight and weight control practices (Aim 2). Finally, we will evaluate the cost effectiveness of DSW compared to SC (Aim 3). Results will allow us to estimate whether DSW mitigates continued age-related weight gain among adults with obesity. If so, DSW could have substantial public health and economic effects by offering a weight management strategy that is feasible to implement in primary care.