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PATHWEIGH: New Primary Care Delivery Process Eliminates Regular Population Weight Gain

4 Minute Read
Doctor with patient in office

Key takeaways:

  • Researchers are finding widespread public health benefits by introducing an intervention called PATHWEIGH being tested in the University of Colorado health system.
  • Since its implementation, this new process has helped stop population weight gain in over a quarter of a million people.
  • PATHWEIGH saved over $15 million dollars for the healthcare system, while being implemented at virtually no cost.

A new care delivery process called PATHWEIGH aims to transform weight management by providing a simple, common-sense way for healthcare teams to better use tools built into electronic medical records (EMR) to overcome barriers and guide treatments. This process, which is being studied in 56 primary care clinics across the University of Colorado (UC) Health System, has already begun to show transformative results.

At the 2025 ADA Scientific Sessions, experts presented on the effectiveness and development of PATHWEIGH. Dr. Leigh Perreault, co-principal investigator of the study and a clinical professor of medicine at the UC School of Medicine said that it’s important to understand that PATHWEIGH is not a weight loss program, but rather a road or pathway for a complete process of care to facilitate and prioritize weight management in the primary care setting. 

Perreault, along with other experts involved in PATHWEIGH, presented some of the results collected over a four-year study of this new process as it was deployed across the UC Health system. The study itself was looking to compare the current standard of care (SOC) being used with the PATHWEIGH intervention. 

At the beginning of the trial, all of the clinics started in the SOC group. Each year, roughly a third of the clinics transitioned to the PATHWEIGH intervention in a “step-wise” approach. The focus of PATHWEIGH, in comparison to the SOC, was to streamline the process in the clinic for someone seeking weight-based care and treatment.

  • SOC: In the SOC group, weight may be discussed during an appointment, but the primary care doctor did not have access to PATHWEIGH tools in the EMR. During these visits, doctors would conduct a brief discussion to gain insights into a person's weight journey. This process was intended to encourage a discussion about weight management strategies or treatments.
  • PATHWEIGH: When clinics transitioned to PATHWEIGH, the process was “turned on” in the clinics’ EMR, helping to guide staff and physician workflow. This included a number of small changes, which were all optional but encouraged. Some of these changes included things like having medical assistants ensure that people seeking treatment complete a weight management questionnaire prior to their visit. It also provided physicians with an embedded document to aid in diagnosing obesity, integrate their pre-visit questionnaire to guide the discussion, and offer options for lab orders, referrals, and reimbursement.

“PATHWEIGH is essentially a primary care redesign project to help create room in already overwhelmed practices for obesity management,” said Dr. Peter Smith, an associate professor in the department of family medicine and medical director of primary care and adult hospital-based practice at the UC School of Medicine.

The results of the study focused primarily on overall population health, versus individual health outcomes, and were impressive. Here are the key findings:

  • The study showed, for the first time, that an intervention in a population of over a quarter of a million people successfully prevented population weight gain, which usually amounts to around 0.5 kilograms (or 1.1 pounds) per year. Population weight gain is an important public health measure that refers to an increase in average body weight across a population (such as a city, country, or age group) over time. So while 0.5 kilograms per year may not sound like a lot for an individual, this result means that PATHWEIGH halted the small increase in weight we would normally observe in an entire group of people over time.
  • Results also showed that PATHWEIGH was able to be implemented at virtually no cost, while generating almost $15 million for the health system over the course of the study. 
  • The results also looked more closely at how the intervention helped individuals receiving care. Of the roughly 275,000 individuals included in the study population, those who had explicit weight-related care at a clinic that was using the PATHWEIGH approach showed greater individual weight loss. Interestingly, even when a person never had explicit weight-related care at these clinics, they were less likely to experience weight gain. For the purpose of the study, explicit weight-related care was defined as those people who received counseling on health behaviors and medicine, a referral to an obesity specialist, or a prescription for a weight management medication.

Given the significant barriers that need to be overcome in order to deliver effective weight management in primary care settings, these results are very promising. Primary care physicians are on the front lines when it comes to caring for individuals living with obesity, and yet they often have little time, resources, or confidence and skills to do this successfully. PATHWEIGH aims to address these challenges by better equipping healthcare teams with already available tools, improving outcomes for people living with overweight and obesity.

“As a clinician, I have been through the process and my confidence in my ability to manage obesity has skyrocketed,” said Smith. “I see our next step as iterating on the tools that we’ve shown can work, improving efficiency, and developing some new approaches to meet additional needs.”

Learn more about weight management and treatments here: