Endocrinologist Leigh Perreault, MD, had long been troubled by the conventional methods employed in everyday medical practices for managing patient weight. Frequently, individuals were dismissed with generic recommendations to improve their diet and increase physical activity, despite these suggestions proving insufficient for meaningful progress.
There came a pivotal moment when Perreault, a distinguished professor in endocrinology, metabolism, and diabetes at the University of Colorado Anschutz School of Medicine, who also practices in Westminster in collaboration with primary care doctors, buried her face in her hands and questioned her own approach. “What am I doing?” she reflected. She was routinely prescribing treatments for diabetes, hypertension, elevated cholesterol levels, and various other comorbidities linked to excess weight.
Perreault came to understand that these pharmaceutical interventions primarily targeted symptoms rather than addressing the underlying issue of weight control. “Patients truly do not wish to rely on these drugs indefinitely,” she observed. “If I could effectively assist them in managing their weight, a significant portion of these associated health problems might resolve on their own.”
This epiphany laid the groundwork for an innovative strategy that would fundamentally transform weight management within primary care environments.
A Structured Program Known as PATHWEIGH
In collaboration with her team, Perreault developed PATHWEIGH, a comprehensive framework designed to guide both patients and primary care providers in prioritizing weight management. This initiative establishes specialized clinic sessions dedicated exclusively to weight-related concerns, allowing healthcare professionals to devote undivided attention to this critical area without it being overshadowed by routine check-ups.
Supported by grants from the National Institutes of Health, PATHWEIGH was implemented across all 56 UCHealth primary care facilities in Colorado to rigorously assess its effectiveness. The initiative encompassed 274,182 patients, positioning it as one of the most extensive randomized controlled trials in the field of weight management to date.
Findings from the study, detailed in Nature Medicine by Perreault and her colleagues, revealed that PATHWEIGH successfully curbed average population-level weight gain by 0.58 kilograms over an 18-month period. This intervention reversed the typical trajectory of gradual weight increase into net loss, carrying profound ramifications for broader public health strategies.
Moreover, the program substantially boosted the likelihood of patients accessing weight-specific interventions. Engagement in PATHWEIGH enhanced the probability of receiving targeted weight care by 23%.
“PATHWEIGH unequivocally eradicated weight gain across our entire primary care network—a feat unprecedented in medical literature,” Perreault emphasized.
Consequently, experts in obesity treatment are increasingly advocating for PATHWEIGH as a potential gold standard in clinical practice. Numerous healthcare organizations nationwide are actively investigating its integration into their services.
Creating a Straightforward Roadmap for Weight Management
Perreault portrays PATHWEIGH as a mechanism for synchronizing patients and healthcare providers toward a unified weight management strategy.
“Consider weight loss medications, surgical options, or structured lifestyle programs as various tools for achieving weight reduction,” she explains. “PATHWEIGH constructs a dedicated pathway upon which these tools can travel, ensuring a streamlined process for anyone seeking weight-related support.”
The implementation started with a straightforward step: clinics displayed prominent signage informing patients that they could schedule dedicated weight management appointments simply by inquiring at reception.
This request triggered an automated sequence in the electronic health records system. Patients were promptly sent a targeted survey, and upon submission, the data seamlessly integrated into the provider’s documentation. Consequently, appointments could bypass redundant history-taking and zero in on actionable recommendations.
“This streamlined workflow dramatically boosted efficiency,” Perreault noted. “Our documentation template essentially became a customizable menu of all possible interventions, consolidating every relevant option into a single, user-friendly platform.”
Eliminating Obstacles and Facilitating Open Discussions
Analysis of 18 months of data indicated that approximately 25% of eligible participants engaged in at least one instance of weight-focused care during the trial period. The majority of these interactions centered on lifestyle guidance, while prescriptions for obesity-fighting medications saw a twofold increase.
In contrast to rigid, uniform weight loss initiatives, PATHWEIGH promoted highly individualized treatment plans tailored to each person’s unique circumstances. It also alleviated the unease that typically accompanies weight discussions in clinical settings.
“A vast number of individuals who require or desire weight management support never actually receive it,” Perreault pointed out. “They either hesitate to request it, or clinicians avoid initiating the topic. When conversations do occur, patients are often advised generically to diet and exercise, leading to no real change. This cycle breeds frustration, embarrassment, and reluctance to seek further assistance. PATHWEIGH creates a supportive environment where patients can confidently say, ‘If you’d like professional help with your weight, we now have a clear process in place to provide it.'”
The Population-Level Impact of Incremental Improvements
Specialists project that escalating obesity prevalence stems from an annual average weight gain of roughly 0.5 kilograms across populations. Halting this progression and achieving even slight reductions could substantially mitigate the obesity crisis on a societal scale.
“Individually, the changes may appear modest, but at a population and public health scale, they represent a transformative achievement,” Perreault asserted.
Further analysis demonstrated that those who benefited from PATHWEIGH’s structured weight care achieved more pronounced losses. Remarkably, even patients not directly involved in interventions experienced diminished weight gain relative to historical norms.
Growing Reach Outside Colorado
Perreault highlights the program’s triumphs as a catalyst for broader implementation. Efforts are progressing to extend PATHWEIGH beyond Colorado’s borders. The Obesity Association, in crafting its inaugural clinical guidelines for obesity management, prominently features PATHWEIGH as an endorsed protocol.
Additionally, five healthcare networks spanning seven states are evaluating PATHWEIGH for adoption, with its developers pursuing formal licensing agreements.
“I’m immensely proud that PATHWEIGH originated, was developed, and validated right here in Colorado,” Perreault concluded. “It serves as the essential framework propelling obesity care into the future.”
