The challenge

Managing obesity is a common challenge, especially for health systems that don’t have robust medical obesity programs. While some health systems are investing in new weight management programs staffed with obesity specialists, workforce and financial limitations make this an unrealistic path for many. These health systems must find ways to support the workforce they have and remove barriers preventing them from providing quality weight management care.

There are many barriers to work through. Specialists, particularly endocrinologists and cardiologists, often see patients with obesity but have limited time to focus on weight management when more acute conditions are present. Primary care providers (PCPs) lack the time and resources to manage obesity effectively and worry about disengaging patients who don’t want to talk about weight management. Both PCPs and specialists struggle to keep up with the rapid rate of innovation in obesity treatments.¹

^*See endnote 2.

^**See endnote 3.

UCHealth is one of many organizations attempting to tackle these barriers. They serve a population where obesity and type 2 diabetes are highly prevalent and often coexist with other cardiometabolic conditions. UCHealth leaders found that only 25% of their adult patients with a BMI of 25 or greater were discussing their weight with their clinicians. This highlighted the urgent need for system-wide improvement.

The organization

UCHealth is a Colorado-based health system that serves patients throughout the state. Its facilities include an academic medical center, multiple community hospitals, and both primary and specialty care clinics. UCHealth’s academic programs use a mixed-specialty approach (e.g., pharmacy and medical students often share classes), which influences their organizational culture by encouraging collaboration across specialties and attracting leaders who support multidisciplinary care. Researchers and patient care teams also overlap, enabling them to test, refine, and scale grant‑funded research within the health system.

The approach

As UCHealth evaluated how to improve obesity care within their health system, they leveraged their collaborative culture to design a program that would meet the needs of their population without needing to hire additional obesity care specialists. Specifically, UCHealth focused on helping a variety of non-obesity specialists provide weight management care. They accomplished this with three key elements.

Element 1: Embedded pharmacists into specialty care teams that often treat patients with obesity, including cardiologists and endocrinologists. The pharmacists support medication selection and access, streamlining prior authorizations. They also support patients with dose titration and side effect management.

Element 2: Established a primary care visit type exclusively for weight management care. Patients opt in for these appointments and complete intake questionnaires ahead of time. This approach ensures that each visit aligns with the patient’s needs and keeps them actively involved in their care. It also prevents them from disengaging patients who don’t want to talk to their PCP about their weight when scheduling visits for other medical needs.

Element 3: Developed an Epic-integrated care process designed to guide specialists and PCPs through referrals, medication selection, and insurance requirements. The tool makes it easier for clinicians (especially those without clinical pharmacist support or specialized obesity training) to make treatment decisions and referrals. They scaled the tool rapidly to 66 clinics, reaching approximately 750,000 patients.

The result

UCHealth’s efforts to remove barriers to weight management support and empower non-obesity specialists ultimately impacted obesity rates at the population level. At the population level, Colorado experiences an average weight gain of 0.47 kg over 18 months, similar to the United States overall. UCHealth’s intervention changed the direction of the trend from weight gain to weight loss. Their patients with obesity lost 0.1 kg on average, a total swing of 0.58 kg over 18 months. Their approach also increased the likelihood that patients would receive weight-related care by 23%.⁴

3 elements that reshaped obesity care at UCHealth

To improve obesity care without building a stand-alone program, UCHealth focused on three key elements that made weight management easier for clinicians and clearer for patients. Together, these elements helped shift obesity care from a specialty service to a shared responsibility across the system.

Results

UCHealth’s approach reshaped how clinicians addressed weight management by empowering non-obesity specialists and making obesity care a shared responsibility. Clinicians reported that they felt more supported and more willing to engage in weight‑related visits because workflows were simpler and conversations were destigmatized.

With the support of an NIH grant, UCHealth researchers tested the impact of the weight management visits and EHR-integrated tools. Combined, these elements had three main impacts:

• Population impact: The elements eliminated population weight gain, changing the trend from 0.47 kg gain at 18 months to a 0.1 kg loss among adults with a BMI of 25 or greater. This represents a meaningful shift in population health.⁴
• Patient impact: Patients who received weight-related care lost an average of 3% of their body weight. Notably, 75% of these patients received only lifestyle advice, while 25% received additional interventions such as medications and referrals.
• Clinician impact: Clinicians reported increased motivation and satisfaction broadly. Each of the interventions made their jobs easier and required minimal training.

Considerations for your organization

UCHealth’s approach to weight management care — namely supporting all providers rather than adding obesity specialists — stands out in a landscape where many health systems struggle to meet rising demand. While their approach was designed for UCHealth’s particular situation, other organizations may consider replicating one or more elements. Use the table below to compare your organization’s gaps and characteristics to UCHealth’s as you evaluate whether each element might be a good fit.

In addition to reflecting on the questions above, leaders can look to peer organizations for perspective. Visit Advisory Board’s weight management landing page for more case studies and examples.

Lilly unites caring with discovery to create medicines that make life better for people around the world. We've been pioneering life-changing discoveries for nearly 150 years, and today our medicines help more than 51 million people across the globe. Harnessing the power of biotechnology, chemistry and genetic medicine, our scientists are urgently advancing new discoveries to solve some of the world's most significant health challenges, redefining diabetes care, treating obesity and curtailing its most devastating long-term effects, advancing the fight against Alzheimer's disease, providing solutions to some of the most debilitating immune system disorders, and transforming the most difficult-to-treat cancers into manageable diseases. With each step toward a healthier world, we're motivated by one thing: making life better for millions more people. That includes delivering innovative clinical trials that reflect the diversity of our world and working to ensure our medicines are accessible and affordable. To learn more, visit Lilly.com and Lilly.com/newsroom or follow us on Facebook, Instagram, Twitter (X) and LinkedIn.

This expert insight is sponsored by Lilly, an Advisory Board member organization. Representatives of Lilly helped select the topics and issues addressed. Advisory Board experts wrote the report, maintained final editorial approval, and conducted the underlying research independently and objectively. Advisory Board does not endorse any company, organization, product or brand mentioned herein.

To learn more, view our editorial guidelines.