Abstract
Background: Over the past 3 years, the COVID-19 pandemic has resulted in seismic changes in healthcare delivery. Intensive behavior therapy (IBT), a strategy for the treatment of obesity, was rapidly adapted to a virtual consultation model, replacing in-person clinic visits. We sought to compare adherence and observed weight loss between patients referred for IBT and followed up by telemedicine and those followed up in person in a bariatric medical practice. Methods: After IRB approval, we conducted a retrospective review of a prospectively maintained dataset of patients referred for clinical bariatric IBT between January 2019 and June 2021 and followed up in person or via telemedicine. The primary outcome was mean weight variance over the follow-up period. Descriptive statistics, Chi-square, and Wilcoxon rank-sum tests were applied as appropriate. The significance level was set at p < 0.05. Results: During the study period, 147 patients were seen for at least one IBT session for weight management: 69 were followed up in person (IP) and 78 via telemedicine (TM). The mean age, baseline BMI, and follow-up were 51.6 ± 13.6 years, 39.0 ± 7.4 kg/m2, and 95.8 ± 114.9 days for the IP group and 50.4 ± 14.7 years, 41.3 ± 8.6 kg/m2 and 77.5 ± 81 days for the TM group. In the IP and TM groups, the loss to follow-up after the first visit was 12.2% and 10.2% (p = 0.3201) and the observed mean weight variance was -1.62 ± 1.89 and - 2.51 ± 1.88 kg/month (p = 0.0359), respectively. Conclusions: For the management of obesity, IBT provided by telemedicine appears to be non-inferior to that provided in person; despite a statistically significant difference in weight variance between the two groups, the observed weight loss as well as the documented patient adherence to subsequent follow-ups was overall similar in both patient groups. However, these results need to be confirmed by an objective assessment of reported weight changes.