Obesity Treatment through Behavioral Coaching

Updated: Jan 12, 2018
Evidence Rating:
Suggestive Tier


  • Program:

    A community-based behavioral coaching program for obese adults, delivered through primary care practices.

  • Evaluation Methods:

    A well-conducted randomized controlled trial (RCT) with a sample of 415 obese patients in six primary care practices in Baltimore.

  • Key Findings:

    As of two years post-random assignment, the program group had lost significantly more weight than the control group (about 8-9 pounds more).

Obesity is a major public health problem in the United States. While studies show it is often feasible for obese individuals to achieve short-term weight loss, most find it difficult to maintain weight loss over time.

In this two-year program for obese adults, trained bachelor’s-level coaches provide advice on weight management through reduced calorie intake and exercise. Program participants also receive web-based learning modules and tools for tracking their weight loss, exercise duration, and calories consumed. The program is delivered in one of two formats:

(i) In-Person Support. Coaches provide up to 57 individual and/or group meetings over two years – initially on a weekly basis, tapering to one or two times per month. The coaches are employed by Johns Hopkins University.

(ii) Remote Support. Coaches provide up to 33 phone calls over two years – initially on a weekly basis, tapering to once per month. The coaches are employed by Healthways, a disease-management company.

The program recruits participants through primary care practices, using physician referral, brochures, and targeted mailings to patients. Participants’ primary care physicians play a supportive role in program delivery, reviewing each participant’s weight-loss progress at routine office visits and encouraging ongoing participation in the program.

The cost of the program is not reported, but the Remote Support version appears to be inexpensive (we estimate the cost of the coaches’ time to be about $112 per participant per year in 2017 dollars).

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Lawrence J. Appel, Jeanne M. Clark, Hsin-Chieh Yeh, Nae-Yuh Wang, Janelle W. Coughlin, Gail Daumit, Edgar R. Miller III, Arlene Dalcin, Gerald J. Jerome, Steven Geller, Gary Noronha, Thomas Pozefsky, Jeanne Charleston, Jeffrey B. Reynolds, Nowella Durkin, Richard R. Rubin, Thomas A. Louis, and Frederick L. Brancati. “Comparative effectiveness of weight-loss interventions in clinical practice.” The New England Journal of Medicine, 2011, vol. 365, pp. 1959–1968.