WEIGHT loss maintenance (WLM) remains one of the most challenging aspects of obesity treatment, often undermining long-term health benefits. Traditional continuous care, involving frequent sessions led by professional staff, shows promise but is costly and difficult to sustain in everyday clinical practice. Consequently, there is a pressing need for effective, scalable models that can support WLM outside of professional-led settings. A recent randomised clinical trial investigated whether a fully patient-delivered intervention could match or surpass standard-of-care (SOC) treatment, finding that this novel approach may offer superior weight maintenance outcomes over 18 months.
The study recruited 287 adults aged 18 to 75 years with a body mass index (BMI) between 25 and 50 from a single academic centre. Participants first completed an online weight loss programme; those who lost at least 5% of their body weight qualified for the second phase. They were then randomised to receive either a patient-to-patient intervention (where successful weight loss mentors led sessions and peers provided ongoing remote support), or a professionally delivered SOC group lifestyle intervention. Both interventions lasted 18 months and aimed to prevent weight regain. The trial measured weight change as the primary outcome, alongside secondary markers including blood pressure, heart rate, physical activity, and sedentary behaviour.
Results showed that 93.4% of participants completed the trial. The patient-delivered intervention group experienced significantly less weight regain compared to the SOC group at 6 months (−1.44 kg versus −0.16 kg), 12 months (0.04 kg versus 0.77 kg), and 18 months (0.77 kg versus 2.37 kg), with a p-value of 0.002 indicating strong statistical significance. Improvements in cardiovascular risk factors such as diastolic blood pressure and heart rate, as well as increased physical activity and reduced sedentary time, were also observed. These findings suggest the patient-to-patient model is at least as effective as traditional care, if not more so. However, limitations include recruitment from a single centre and the predominantly female sample, which may affect generalisability. Further research is warranted to validate these results in broader clinical and community contexts and to assess long-term sustainability and cost-effectiveness.
This study highlights the potential for patient-delivered interventions to transform clinical practice by reducing reliance on costly professional resources while enhancing patient engagement and outcomes. Implementing mentor- and peer-supported WLM programmes could provide a practical, scalable alternative for obesity management within healthcare systems.
Reference
Leahey TM et al. Patient-Delivered Continuous Care for Weight Loss Maintenance A Randomized Clinical Trial. JAMA Intern Med. 2025;DOI: 10.1001/jamainternmed.2025.1345.
