Working long hours can take a toll on your health. The Lackey Law Firm in Huntsville, Alabama, understands this, which is why they launched a comprehensive employee wellness program focused on weight management. It's been more than just a program; it's a journey of transformation for many of their team members, reflecting their commitment to creating a supportive and healthy work environment. Isn't a thriving, healthy workforce a key ingredient to success?
A Holistic Approach to Weight Management
The firm recognized that a "one-size-fits-all" approach wouldn't be effective. Everyone's journey is unique, with individual needs and challenges. So, they developed a flexible and supportive program designed to fit busy lives and accommodate life's unexpected events. It's about making sustainable, healthy changes, not about quick fixes or restrictive diets.
Key Program Components: A Multifaceted Approach
The Lackey Law Firm's weight management program is multifaceted, incorporating several key components to support employees in their health journeys:
- Nutritional Guidance: Partnering with registered dietitians to provide personalized guidance, meal planning, and education. The focus is on empowering employees with knowledge to make informed food choices for long-term success, not on restrictive dieting.
- Fitness Support: Offering subsidized gym memberships and on-site fitness classes (yoga, Zumba, etc.) catering to diverse interests and fitness levels. Fun, engaging wellness challenges further foster a supportive community and promote consistent participation.
- **Mental Wellness: Stress significantly impacts overall health, including weight management. Access to mental health resources (workshops, counseling, employee assistance programs) is integral to the program. A healthy mind is just as crucial as a healthy body.
- Community and Support: Regular group meetings foster a supportive environment where employees share experiences, offer encouragement, and find strength in numbers. This community aspect is key to long-term success and motivation.
Employee Success Stories: Inspiring Transformations
The success of the Lackey Law Firm's weight management program is best illustrated through the stories of its employees.
Sarah, a paralegal, says, "The program helped me regain my energy and focus. I sleep better, and I feel fantastic! The weight loss is a bonus; it's the overall improved well-being that matters most."
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John, an associate attorney, shares, "I lost 20 pounds, which dramatically improved my blood pressure. This wasn't just about a number on the scale; it was a journey toward a healthier, happier me."
These are just two examples of the many positive transformations within the team.
Quantifiable Results: A Testament to Success
While individual experiences are unique, the program’s measurable results demonstrate its effectiveness.
| Metric | Result |
|---|---|
| Average Weight Loss | 15 pounds |
| Improved Blood Pressure | 80% reported improvement |
| Increased Energy Levels | 95% reported enhanced energy levels |
| Improved Sleep Quality | 75% reported better sleep quality |
These figures highlight tangible improvements in overall health and well-being. But these numbers are only part of the story; the real success lies in the individual transformations and renewed sense of purpose within the team.
Addressing Challenges: Celebrating Progress, Embracing Setbacks
Weight loss isn't always a smooth journey. There will be ups and downs, plateaus, and setbacks. That’s why ongoing support and flexibility are crucial. The Lackey Law Firm provides continued guidance, emphasizing that consistency requires patience and understanding. They encourage their employees to view setbacks as learning opportunities and celebrate every milestone, no matter how small.
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A Culture of Wellness: Investing in Employees
The Lackey Law Firm weight loss program reflects a fundamental shift in the company culture-a deep commitment to employee well-being that extends beyond physical health to encompass mental and emotional well-being. Investing in their employees' health is an investment in the firm’s overall success. This is just the beginning; they're continually evaluating and improving the program to ensure it meets the evolving needs of their team.
Community-Based Weight Management Programs: A Scalable Model for Comprehensive Obesity Care
Current strategies for obesity management in primary care leave many patients inadequately treated or unable to access treatment entirely.
Methods
An 18-month pre/postintervention study was conducted.
Results
The program served 550 patients over 1,952 visits from March 2019 through October 2020. A total of 209 patients had adequate program exposure, defined as four or more completed visits. Among these, all received targeted lifestyle counseling and 78% received antiobesity medication. Patients who attended at least four visits had an average TBWL of 5.7% compared to an average gain of 1.5% total body weight for those with only one visit.
Conclusion
A community-based weight management program delivered by obesity medicine-trained primary care providers effectively produces clinically significant weight loss. Obesity affects 42% of US adults, with persons of low socioeconomic status disproportionately being burdened.
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Enhancing Access to Obesity Care in Primary Care Practices
Most treatment still occurs in centralized multidisciplinary centers or commercial clinics with high out-of-pocket costs. As most health care interactions occur in primary care practices, providing weight management services in the same locations enhances patient access to obesity care and is expected to improve health outcomes. However, the time constraints in primary care practices and lack of obesity-specific training are major barriers to obesity treatment in communities. Moreover, clinical guidelines underscore that intense behavioral therapy alone is insufficient to achieve sustained weight loss for most patients, necessitating the consideration of antiobesity medication (AOM) when bariatric surgery is declined.
A Weight Management Program Utilizing Obesity Medicine-Trained Primary Care Providers
To increase access, a weight management program (WMP) was piloted utilizing obesity medicine-trained primary care providers (PCPs) nested in primary care practices. The effectiveness of such a nested WMP for clinically meaningful weight loss in community-based practices was evaluated as a scalable model for delivering comprehensive obesity care.
Program Structure and Staffing
The WMP was piloted in three primary care clinics. Three PCPs certified in weight management by the American Board of Obesity Medicine were assigned visits dedicated to obesity care, charging primary care copays. Staffing included registered dieticians (RD) and licensed clinical social workers (LCSW) as part of a primary care medical home. All clinical staff were existing employees. Primary care physicians at the three pilot sites were informed of the study.
Patient Evaluation and Treatment
The physician and RD evaluated all new patients. Evaluations included weight history, eating behaviors, physical activity, sleep, stress, physical exam, and metabolic data. Patients with uncontrolled mental health diagnoses were referred to LCSW. When AOMs were initiated, preference was given to FDA-approved agents. The program offered targeted lifestyle counseling (TLC; 6-8 sessions per year) plus AOMs. The obesity-certified PCPs were involved in every follow-up visit. Visits were 20 minutes in duration and primarily structured to address lifestyle changes. Goals were reviewed, positive behaviors were reinforced, and strategies were discussed to work on unmet goals. Antiobesity medications were also titrated. Since weight loss has a profound impact on so many comorbidities, significant conditions, such as hypertension, nonalcoholic fatty liver disease, obstructive sleep apnea, and type 2 diabetes, were regularly addressed, and cardiometabolic medications were titrated down or removed.
Financial Stability and Patient Tracking
The program maintained financial stability for the clinics. All three clinicians were able to meet their goals for standard work relative value units (wRVU). Patients enrolled in the WMP were tracked in an obesity registry. Health and demographic data were extracted and analyzed for patients 18 or older with body mass indexes (BMIs) above 27 kg/m2 and adequate program exposure, defined as at least four visits. BMI inclusion was based on current practice guidelines. The comparison group was patients with similar age and BMI criteria but only one assessment visit in the WMP and no follow-up visits or interventions.
Outcomes and Analysis
The primary outcomes were the percent weight loss postintervention and the proportion of patients who achieved a clinically significant TBWL of 5% or greater. The data was analyzed using Stata/SE software version 16.1. Paired t tests were performed to assess differences in continuous variables. Statistical significance was established at ɑ=0.05. The latest weight and BMI were compared to the baseline values at the program's start to determine changes in outcomes. The University of North Carolina at Chapel Hill’s Institutional Review Board approved the study.
Patient Demographics and Program Exposure
From March 2019 through October 2020, the WMP’s three pilot clinics served 550 new patients over 1,925 visits. The mean patient age was 49.0 years (SD 13.3), with a starting weight and BMI of 110.2 kg (SD 23.5) and 40.0 kg/m2 (SD 7.7), respectively. For inclusion in the analysis, 209 patients had adequate program exposure (≥4 visits) and 66 patients were in the comparison group (assessment without follow-up). The mean weight change was -5.7% (SD 5.8%), average attendance was 6.3 visits (SD 2.6), and mean follow-up was 241 days (SD 127). Fifty three percent (n=111) achieved at least 5% TBWL with 6.8 mean visits. Twenty percent of patients achieved 10% TBWL or more. The comparison group had a mean weight gain of 1.5% over an average of 407 days (SD 158). The weight loss appeared to co-relate with the number of visits completed, with patients achieving TBWL of at least 5% between the fourth and fifth visit.
Discussion: Impact of Obesity Medicine-Trained PCPs on Weight Loss
The purpose of the WMP was to explore the impact of obesity medicine-trained PCPs on durable weight loss in communities. During the WMP pilot, patients achieved a clinically meaningful weight loss of approximately 5% after attending at least four visits. Half of the patients (53%) achieved 5% weight loss compared to the marginal weight gain in individuals who only received the initial assessment. There is growing evidence that moderate weight loss can significantly improve outcomes of many obesity-related comorbidities. Accordingly, obesity treatment strategies can and should include community-based solutions to improve access to care and improve obesity-related outcomes.
Strengths and Scalability of the Study
This study's strength is its achievement of significant weight loss in real-world community settings serving patients from diverse socioeconomic and underrepresented racial groups. The weight management certification of the physicians is not necessarily a critical component of the intervention. Easy access to obesity medicine-certified mentors is key to providing effective, evidence-based obesity treatment in low-resource community settings. For example, an information dissemination technique similar to the ECHO (Extension of Community Healthcare Outcomes) Model can be used. Monthly, virtual obesity medicine meetings with community clinicians discussing the latest obesity literature and difficult clinical cases can be held. These meetings also build relationships such that PCPs can have access to experienced obesity clinicians.
Conclusion: A Scalable Model for Expanding Access to Obesity Treatment
This approach represents a potential scalable model for expanding access to comprehensive, effective obesity treatment for the general population.