A Colorado Doctor's Simple Fix Is Stopping Weight Gain Across Entire Clinics—Here's How

A revolutionary approach to weight management in primary care clinics has successfully halted population weight gain across an entire health system. The PATHWEIGH program, developed by Colorado endocrinologist Dr. Leigh Perreault, reduced average weight gain by 0.58 kg over 18 months and shifted the overall trend from steady gain to weight loss in a massive trial involving 274,182 patients.

What Makes PATHWEIGH Different From Traditional Weight Care?

Unlike the typical "eat less, exercise more" advice, PATHWEIGH creates a structured pathway for patients to receive dedicated medical support for weight management. The system allows patients to request appointments focused entirely on weight care by simply asking at the front desk, which automatically triggers a specialized workflow in the electronic health record.

"There was a moment I put my face in my hands and thought, 'What am I doing?' I would write a lot of prescriptions for patients' diabetes, their blood pressure, their lipids and all these other conditions," said Dr. Perreault, a professor of endocrinology, metabolism and diabetes at the University of Colorado Anschutz School of Medicine. "None of these people want to be on these medications and I thought if I could just help them with their weight, many of these health concerns would probably go away."

How Does the PATHWEIGH System Actually Work?

The program removes common barriers that prevent patients from receiving weight-related care through several key components:

• Clear Request Process: Clinics post signs letting patients know they can request weight-focused appointments at the front desk, eliminating awkward conversations
• Automated Workflow: Patient requests automatically activate specialized templates in electronic health records, making visits more efficient
• Dedicated Visit Time: Providers can concentrate specifically on weight-related care instead of squeezing it into standard appointments
• Customized Treatment Menu: The system turns clinical notes into comprehensive menus of available interventions for each patient

The results were impressive across the 56 UCHealth primary care clinics throughout Colorado. About one in four eligible patients received some form of weight-related care at least once during the 18-month trial, and prescriptions for anti-obesity medications doubled during the intervention.

Why Are Health Systems Racing to Adopt This Model?

The program's success has caught the attention of obesity specialists nationwide, who are pointing to PATHWEIGH as a possible standard of care. Five health systems across seven states are now considering adopting the model, and the Obesity Association is highlighting it in their first-ever standards of care for obesity.

"With PATHWEIGH, we showed that we absolutely eliminated population weight gain across all of our primary care, which has never been done previously," Dr. Perreault explained. The approach addresses a critical gap in healthcare, where most people who want or need weight-related care never receive it due to system barriers and uncomfortable conversations.

However, recent research highlights the importance of comprehensive approaches to weight management. A systematic review of 37 studies involving 9,341 participants found that stopping weight management medications leads to rapid weight regain at an average rate of 0.4 kg per month, with all beneficial effects on heart health markers projected to return to baseline within 1.4 years. This finding underscores why programs like PATHWEIGH, which combine medication access with lifestyle support, may be crucial for long-term success.

The timing couldn't be better, as the Centers for Medicare & Medicaid Services recently announced the BALANCE Model, a new voluntary program designed to expand access to glucagon-like peptide-1 (GLP-1) medications like Ozempic and Wegovy while controlling costs. The program will launch in Medicaid as early as May 2026 and in Medicare Part D in January 2027.