Changes in healthcare utilization after lifestyle intervention for weight loss

Introduction: This study evaluates the real-world impact of a lifestyle change program (LCP) on healthcare utilization in a large health system.

Methods: Using electronic health record (EHR) data from a large health system in northern California, United States, LCP participant and propensity-score-matched non-participant outcomes were compared in the second year post-participation: (1) overall healthcare utilization, and (2) utilization and medications related to cardiometabolic conditions and obesity. Adult LCP participants between 2010-2017 were identified and matched 1:1 with replacement to comparable non-participants. Participants without EHR activity in the 12-36 months before baseline, or with conditions or procedures associated with substantial weight change, were excluded. Statistical analysis and modeling were performed in 2021-22.

Results: Compared to matched non-participants, LCP participants in the 12-24 months post-baseline were more likely to have specialty-care visits (+4.7%, 95% CI +1.8%,+7.6%), electronic communications (8.6%, 95% CI +5.6%,+11.7%), and urgent-care visits (+6.5%, 95% CI +3.0%,10.0%). Participants also had more office visits for cardiometabolic conditions and obesity (+1.72 visits/patient, 95% CI +1.05,+2.39).

Conclusions: Compared with matched non-participants, LCP participation was associated with higher utilization of outpatient services post-participation. Additional research could assess whether this indicates an increase in preventive care that could lead to improved future outcomes.