Redesigning Primary Care Workflows to Optimize Obesity Management

Photo Credit: iStock.com/Jacob Wackerhausen

The PATHWEIGH trial aims to embed structured obesity care into primary care, addressing barriers and boosting clinician confidence and patient outcomes.

As rates of obesity continue to rise alongside new therapeutic options, a team of researchers at the 85th Scientific Sessions of the American Diabetes Association (ADA) will present findings from PATHWEIGH, a pragmatic clinical trial designed to embed evidence-based obesity care directly into primary care workflows.¹

Despite the high and rising prevalence of obesity in the United States—impacting over 40% of adults—most primary care clinics are not equipped to deliver consistent, evidence-based obesity care. Barriers include time constraints, lack of training in obesity treatment, limited reimbursement, and the absence of structured care pathways.²

As a result, obesity may be underprioritized in routine visits, and patients may miss opportunities to manage a chronic disease that significantly raises the risk of diabetes, cardiovascular disease, and some cancers.

This unmet need is compounded by growing therapeutic options that primary care physicians may be unfamiliar with or uncomfortable prescribing. In addition, behavioral and lifestyle interventions, which are foundational to long-term weight management, are difficult to coordinate within the confines of short primary care visits.

Led by investigators from the University of Colorado School of Medicine, PATHWEIGH is not intended to be a weight loss program, but rather a scalable framework for enabling systematic obesity care within primary care settings.

The trial was implemented across 56 UCHealth primary care clinics, offering clinicians tools and protocols to deliver individualized, adaptable obesity care based on patient preferences, access, and medical need. Through this model, PATHWEIGH seeks to improve both the clinical delivery of weight management services and patient outcomes.

Co-principal investigators Jodi Summers Holtrop, PhD, and Leigh Perreault, MD, emphasized that PATHWEIGH intends to give primary care clinicians a road to prioritize weight management with their patients. Dr. Holtrop will detail how PATHWEIGH’s infrastructure reshapes team-based care to support long-term outcomes.

Mark Gritz, PhD, noted that PATHWEIGH uses an electronic health record-based approach to generate robust real-world data.

From the clinician perspective, Peter C. Smith, MD, described PATHWEIGH as a “primary care redesign project.” He noted improved confidence in obesity management among clinicians and a clear benefit to patients who engage with the process.

Robert Kushner, MD, will conclude the session with a commentary on PATHWEIGH’s implications for integrating obesity treatment into the mainstream of primary care.

The symposium, titled “PATHWEIGH Trial—Building the Highway for Weight Management in Primary Care,” will be held in Chicago on June 20, 2025, with on-demand access available from June 25 through August 25.