Briefly describe a specific question, or set of related questions, about a health care test or treatment that this program should consider.

How do normal weight adults, including those who have always been normal weight and those who have had successful long-term weight loss, succeed in weight management in the face of a work, leisure, and dietary environment that is responsible for the global obesity epidemic? Can this "community knowledge" help in the development of tailored work, leisure, dietary, and medical interventions to more effectively meet the weight management needs of specific subgroups of patients?

Does your question include a comparison of different health care approaches? (If no, your topic will still be considered.)

yes

If yes, explain the specific technologies, devices, drugs, or interventions you would like to see compared:

The project will create and follow a registry of patients categorized by weight category (BMI 20-30; >30 -40; >40), gender, socioeconomic status, and race. Tailored interventions will be developed based on knowledge gained from those who have been successful in their weight management.

What patients or group(s) of patients does your question apply to? (Please include specific details such as age range, gender, coexisting diagnoses, and indications for therapy.)

A diverse population of adults (18 and older), drawn from practice-based research networks across the United States.

Are there subgroups of patients that your question might apply to? (For example, an ethnic group, stage or severity of a disease.)

Patients at increased risk of overweight and obesity including those who are genetically predisposed, patients with co-morbid medical conditions, and certain life transitions (such as, loss of a love one, retirement, childbirth)

Describe the health-related benefits you are interested in. (For example, improvements in patient symptoms or problems from treatment or diagnosis.)

Morbidity and mortality from cardiovascular disease, diabetes, arthritis, and other chronic diseases could be reduced.

Describe any health-related risks, side effects, or harms that you are concerned about.

None

Appropriateness for EHC Program

Does your question include a health care drug, intervention, device, or technology available (or likely to be available) in the U.S.?

no

Which priority area(s) and population(s) does this topic apply to? (check all that apply)

EHC Priority Conditions (updated in 2008)

• Arthritis and nontraumatic joint disorders
• Cardiovascular disease, including stroke and hypertension
• Diabetes mellitus
• Obesity

AHRQ Priority Populations

• Low income groups
• Minority groups
• Women
• Elderly
• Individuals with special health care needs, including individuals with disabilities or who need chronic care or end-of-life health care

Federal Health Care Program

• Medicaid
• Medicare

Importance

Describe why this topic is important.

Little is understood on how normal weight is successfully maintained over the course of life.

What specifically motivated you to ask this question? (For example, you are developing a clinical guideline, working with a policy with large uncertainty about the appropriate approach, costly intervention, new research you have read, items in the media you may have seen, a clinical practice dilemma you know of, etc.)

As clinicians we have noticed that some patients have been successful in their weight management in spite of genetice predisposition and a work, leisure, and dietary environment that predisposes to overweight and obesity. At least 30% of the population is normal weight and this group of individuals many be a valuable source of information, insights, and strategies for the prevention and treatment of obesity.

Does your question represent uncertainty for clinicians and/or policy-makers? (For example, variations in clinical care, controversy in what constitutes appropriate clinical care, or a policy decision.)

yes

If yes, please explain:

Current strategies for weight reduction and weight loss have had minimal impact on the obesity epidemic. The options for treating patients who are overweight are limited.

Potential Impact

How will an answer to your research question be used or help inform decisions for you or your group?

The knowledge and insights gained from patients who are successful in weight management will help us develop tailored interventions for the prevention and management of obesity.

Describe the timeframe in which an answer to your question is needed.

The obesity epidemic and associated morbidity and maortality is spreading rapidly across the globe. Existing interventions have had a minimal impact on this epidemic and solutions are needed as soon as possible.

Describe any health disparities, inequities, or impact on vulnerable populations your question applies to.

Obesity affects the rural, poor, and minorities disproportionally,possibly because resources (such as food outlets, exercise opportunities, others) are limited and the burden of associated co-morbidities is greatest in this population. The knowledge gained from those who successfully manage their weight in these populations may be especially informative.

Nominator Information

Other Information About You: (optional)

Please choose a description that best describes your role or perspective: (you may select more than one category if appropriate)

The knowledge and insights gained from patients who are successful in weight management will help us develop tailored interventions for the prevention and management of obesity.

Are you making a suggestion as an individual or on behalf of an organization?

Individual

Please tell us how you heard about the Effective Health Care Program