A Short Weight Loss Intervention in a Neurosurgical Subspecialist Clinical Setting

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Context: The relationship between back pain and obesity is well characterized; therefore, the neurosurgical consultant visit for back pain may be a key interventional opportunity for weight loss. Aims: The aim of this project was to evaluate efficacy of an educational intervention for back pain. Methods: A retrospective study was undertaken to evaluate effectiveness of an educational intervention (Show patient's own MRI, Explain degenerative disc disease, Relate to weight issues, Reference other weight-related comorbidities, and Encourage a plan of action for weight loss [SERRE]). This has been performed since 2014 for patients presenting to the first author's neurosurgical spine clinic with nonsurgical back pain and body mass index (BMI) over 35. Results: The average BMI was 50.7. Fifty-five percent of patients had additional weight-related comorbidities. After SERRE intervention, 82% of patients were open to weight loss interventions. However, only 22% of patients went on to follow-up with a formal weight management program and only 9% of patients went on to have a documented weight loss. The lack of success was largely attributed to social issues and severe medical comorbidities within the specific population. Conclusions: Incorporation of patient education regarding the relationship of weight loss to back pain and other weight-related comorbidities is well received in a rural specialist consultation setting. Improved communication with primary care physicians regarding this message and further supportive actions may improve follow-through, and therefore success of ultimate weight loss interventions.