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Treating obesity in primary care settings is difficult in any population, but particularly in underserved populations. In this trial, 18 primary care clinics in Louisiana were randomized to provide either an intensive lifestyle intervention or usual care to 803 obese adults (mean body-mass index, 37 kg/m2). About 40% of patients had annual family incomes lower than US$20,000, 78% attended a federally qualified health center, and 30% had a health-literacy level of lower than ninth grade. Two thirds of patients were Black, and 84% were women.
The intervention, delivered by trained health coaches, consisted of frequent in-person visits and telephone sessions and included instruction on increasing physical activity and personalized diet plans. P…