# PATHWEIGH: pragmatic weight management in primary care

> **NIH NIH R18** · UNIVERSITY OF COLORADO DENVER · 2020 · $571,307

## Abstract

Project Summary/Abstract
Obesity – with its many comorbid conditions – has now surpassed smoking as the leading cause of preventable
death in the United States. Despite the fact that obesity is both treatable and preventable, treating the
comorbidities, rather than obesity per se remains the mainstay of therapy. Importantly, obesity is being
increasingly recognized not only as a risk factor for disease, but a disease unto itself. Despite this fact, <1% of
people with any degree of overweight or obesity are offered anything other than lifestyle advice. Reasons for
lack of weight management prioritization are extensive and complex. Effectively, the major stakeholders,
including people with obesity, their clinicians and insurers, have yielded to the epidemic. Thus, there is a
critical need to systematically address these diverse barriers with pragmatic approaches and evidence that
facilitates the practice of weight management. To address this gap, the University of Colorado Health Family
Medicine clinic in Westminster, Colorado developed PATHWEIGH. PATHWEIGH prioritizes weight
management in primary care by: 1) using a designated, time-efficient flowsheet built into EPIC (the most
widely utilized electronic medical record (EMR) system in the U.S.) that guides and captures history around
weight gain and recommendations for weight loss, as well as practical issues related to diagnosis and billing,
and 2) clinician and team training on a) use of PATHWEIGH as a tool, and b) education on current effective
practices for weight management. Our pilot study demonstrated the ability to effectively implement
PATHWEIGH in a primary care clinic that lead to significant improvement in patient weight loss over 18
months. The overall objective for the proposed work is to test the effectiveness of PATHWEIGH vs. standard of
care in 57 primary care clinics that span diverse settings, patient populations and community contexts, as well
as to examine methods to optimize implementation. Our specific aims include: 1) Evaluate the implementation
of PATHWEIGH and determine its effectiveness versus control clinics using standard of care (SOC) on patient
weight loss at 6 months (primary) and weight loss maintenance at 12 and 18 months (secondary) for weight-
prioritized visits in primary care, 2) Identify predictors of patient weight loss and weight loss maintenance
using mediator and moderator analysis, including relevant patient, provider and clinic-level variables, and 3)
Examine contextual factors affecting the adoption, implementation and sustainability of PATHWEIGH using
the Practical, Robust, Implementation and Sustainability Model (PRISM). To complete these aims, we will
utilize a stepped wedge cluster randomized trial. Data collection and analysis methods include clinical data,
surveys, observations and interviews using statistical, qualitative and mixed methods. PATHWEIGH has the
potential to be a scalable, low-cost, pragmatic approach to obesity. The rationale that ...

## Key facts

- **NIH application ID:** 10105800
- **Project number:** 1R18DK127003-01
- **Recipient organization:** UNIVERSITY OF COLORADO DENVER
- **Principal Investigator:** JODI Summers HOLTROP
- **Activity code:** R18 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $571,307
- **Award type:** 1
- **Project period:** 2020-09-17 → 2025-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10105800

## Citation

> US National Institutes of Health, RePORTER application 10105800, PATHWEIGH: pragmatic weight management in primary care (1R18DK127003-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10105800. Licensed CC0.

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