Colorado Clinic Stops Weight Gain for 274,000 Patients

Dr. Leigh Perreault sat in her office feeling frustrated about prescribing yet another round of medications for diabetes, high blood pressure, and cholesterol when she knew the real problem was weight. She realized she was treating symptoms instead of helping patients address the root cause of their health struggles.

That moment of clarity led Perreault, an endocrinologist at the University of Colorado, to create PATHWEIGH. The program gives patients a judgment-free way to request help and gives doctors the tools to focus entire visits on weight management instead of squeezing it into regular appointments.

The system works surprisingly simply. Clinics posted signs telling patients they could request a weight-focused appointment at the front desk. That request triggered an automatic workflow in the electronic health record, sending patients a survey that fed directly into their doctor's notes. The streamlined process turned each visit into a clear menu of treatment options tailored to each person.

With funding from the National Institutes of Health, UCHealth rolled out PATHWEIGH across all 56 of its primary care clinics throughout Colorado. The pilot included 274,182 patients, making it one of the largest randomized trials ever conducted in weight management.

The results, published in Nature Medicine, exceeded expectations. Over 18 months, the program eliminated population weight gain entirely and shifted the trend toward weight loss. Patients became 23% more likely to receive actual weight-related care instead of generic advice to eat less and exercise more.

Prescriptions for anti-obesity medications doubled during the trial. About one in four eligible patients received some form of medical weight support, most commonly lifestyle counseling customized to their specific needs.

The Ripple Effect

The program solved a problem that has plagued medicine for decades. Most people who need weight care never ask for it because previous attempts left them embarrassed and frustrated. Doctors often avoid bringing it up because they lack the time and tools to provide real help during packed appointments.

PATHWEIGH created what Perreault calls "a highway for all the vehicles of weight loss" including medication, surgery, and structured programs. It gave both patients and doctors permission to address weight as a medical issue requiring medical solutions, not just willpower.

Experts note that rising obesity rates are driven by an average population weight gain of about half a kilogram per year. Stopping that increase and reversing it, even modestly, could make a meaningful dent in slowing the obesity epidemic at a population level.

Health systems across the country are now exploring how to adopt PATHWEIGH as a possible standard of care. Obesity specialists are pointing to the program as a model for how primary care can finally deliver effective weight management at scale.

Perreault's simple realization that weight deserves dedicated medical attention has opened a clear path for hundreds of thousands of patients who previously had nowhere to turn.