Daily Self-Weighing for Obesity Management in Primary Care

项目总结/摘要 大多数肥胖的成年人体重继续增加。虽然初级保健临床指南建议提供 肥胖患者接受强化体重管理治疗或转诊， 到交付。即使提供，许多患者也没有时间或资源参与。鉴于此，沿着 随着减肥和保持体重的挑战，一个减少伤害的框架专注于破坏 在肥胖的初级保健患者中持续的年龄相关性体重增加可能是减轻肥胖的一种策略。 肥胖对健康的不良影响自我调节理论表明，每日自我称重（DSW;即，指令 每日称重并监测体重）提供了一种简单的方法， 肥胖我们和其他人已经表明，DSW与更好的体重管理有关，可能是理想的 初级保健，因为它的低负担和一致性的临床指南建议自我- 监测诸如血压和葡萄糖的健康参数。然而，DSW的效果， 在成人肥胖症患者的初级保健中实施的情况尚不清楚。因此，我们建议进行SWOP （每日自我称重用于初级保健中的肥胖管理），一项为期24个月的随机对照试验 (RCT)在400名患有肥胖症的成年人中（即，体重指数[BMI]：kg/m2 ≥30）通过初级保健接受治疗 临床网络附属于伯明翰的亚拉巴马大学（UAB）。参与者将获得 体重管理教育材料，然后随机分配至DSW或标准治疗（SC）。社会福利署署长会 包括提供一个网络数字秤，并提供图形重量反馈，而SC将包括例行程序 在乎我们将测试分配到DSW对体重（主要结局）和自我启动的因果关系 在24个月内采用体重管理实践（次要结局）（目标1）。我们还将测试 DSW依从性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 与SC相比，DSW的成本效益（目标3）。结果将使我们能够估计DSW是否减轻 肥胖成年人中与年龄相关的体重持续增加。如果是这样的话，DSW可能会有大量的公共卫生 和经济效益，提供了一个体重管理策略，是可行的，在初级保健实施。

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.