You are hereHomeDivisionsMetabolic and Weight Loss Surgery Metabolic and Weight Loss Surgery Minimally Invasive Procedure Can Move Heartburn Patients Off Medication EMBARK: Exploring Massage Benefits in Arthritis of the KneeIn collaboration with Rutgers and Yale, EMBARK is a randomized controlled trial comparing the effectiveness of Swedish massage and light touch bodywork in reducing pain and increasing function of adults with osteoarthritis of the knee. Enrollment is now complete for this study. For more information, please contact Elizabeth Bechard at 919-660-6762. You can also view more information about the study at ClinicalTrials.gov. PRIMIER: Patients Receiving Integrative Medicine Interventions Effectiveness StudyIn collaboration with a network of integrative medicine clinics across the country, PRIMIER is a registry study following the impact of integrative medicine on patients over time.  Individuals who have been seen at Duke Integrative Medicine are eligible to participate.

For more information, please contact Elizabeth Matteson Bechard at 919-660-6762 or elizabeth.matteson@duke.edu. This study examines a pilot project to introduce integrative health coaching to two community and clinical sites, Healing with CAARE and the Healthy Lifestyles program at Duke Pediatrics. For more information, please contact Sarah Cassel at sarah.cassel@dm.duke.edu. Genetic Risk and Health Coaching for Type 2 Diabetes and Coronary Heart DiseaseFree Puppies For Sale In Reno Nv (U.S. Air Force funded) Wedding Dress Train ExtensionsThe purpose of this study is to examine whether the use of genetic test information and/or health coaching in patient risk counseling for heart disease and diabetes affects health behaviors and health outcomes in active-duty Air Force, beneficiaries or dependents and Air Force retiree patients. New Paint Peeling On Bathroom Ceiling

Participants are being recruited from the David Grant Medical Center at Travis Air Force Base and the McClellan Outpatient Satellite Clinic in California. For more information about Duke Integrative Medicine and our various services and programs, please join our mailing list.The Research Study for Weight Management is an evaluation of two weight loss programs offered through LIVE FOR LIFE. The study is open to most Duke employees who take part in a Duke health plan and are eligible for the Steps to Health for Weight (STH) or Pathways to Change (PTC) employee wellness programs. You will need to schedule a Health Check with LIVE FOR LIFE staff to find out if you meet all the criteria for taking part. If you take part in the study, you will be asked to answer questions about your diet, physical activity and about the effects of weight on your life and work. We will weigh you and provide you with links to questionnaires four times during the study: The researchers will also ask for your permission to review your health care use and worker's compensation claims you may submit during the study period.

All of your health information will be handled confidentially: your name will not be attached to any information in the final report. You will be reimbursed up to $100 for your participation. You can also earn up to $1,000 LIVE FOR LIFE dollars. You will also have the satisfaction of knowing that you are helping researchers determine if one program is more effective than the other in helping employees lose weight and maintain their weight loss up to a year after the program is over, and whether weight loss helps improve overall health and decreases the likelihood of being injured on the job. A multidisciplinary research team is conducting this study. The principal investigator is Truls Ostbye, a professor in the Department of Community and Family Medicine at Duke. Recruitment for the study takes place during the LIVE FOR LIFE HealthChecks. Learn more about scheduling a HealthCheck appointment. If you have questions or would like to change your contact information, email the study coordinator at lfl.study@duke.edu.

In a cost-effectiveness analysis of commercial diet programs and pills, the Weight Watchers program and the drug Qsymia showed the best value for the money. The Jenny Craig regimen generated the greatest weight loss, but was also the most expensive option tested, according to Eric Finkelstein at Duke-National University of Singapore (NUS) Graduate Medical School and the Duke Global Health Institute. The findings, published in the June issue of the journal Obesity, provide important information on the health and weight-loss benefits per dollar spent as insurance carriers consider coverage for weight loss programs and drugs. “The obesity epidemic is raising serious health and cost consequences, so employers and third-party payers are beginning to consider how to provide some coverage for commercial weight loss programs,” said senior author Finkelstein, who is professor at Duke-NUS and the Duke Global Health Institute. “These results will help them make better purchasing decisions to maximize the health gains using available resources.”

Finkelstein and research assistant Eliza Kruger first conducted a literature review to identify high-quality clinical trials of commercially available diet/lifestyle plans and medications with proven weight loss at one year or more. Weight loss was measured in terms of absolute change in kilograms lost compared to a control group in which patients underwent a low cost/low intensity intervention, or a placebo in the case of the pharmaceutical trials. Three diet/lifestyle programs and three medications met the inclusion criteria for the cost-effectiveness analysis: Weight Watchers, Jenny Craig and VTrim, along with the diet pills Qsymia, Lorcaserin and Orlistat. Several meal replacement products were excluded despite showing some weight loss success -- including Medifast, Optifast and Slimfast – because they did not meet one or more inclusion criteria. Weight-loss surgery was also excluded. In terms of cost, Weight Watchers was shown to be the least expensive intervention, consisting of an average annual cost of $377.

The expected annual cost for Vtrim users was $682. Because of the relatively high cost of Jenny Craig food, it was the most expensive intervention, with an annual cost of more than $2,500. Expected annual costs for the diet pills was $1,743 for Lorcaserin; and $1,336 for Qsymia. Average weight loss at one year ranged from 2.4 kg (about 5 pounds) for Weight Watchers to 7.4 kg (16 pounds) for Jenny Craig. Those on Orlistat lost 2.8 kg (a little more than 6 pounds) whereas those on Vtrim and Lorcaserin both lost an average of 3.2 kg (about 7 pounds). Weight loss for those on Qsymia averaged 6.7kg (a little less than 15 pounds). Based on the cost and weight-loss data, the average cost per kilogram lost ranged from $155 per kg for Weight Watchers to $338 or more for Jenny Craig. Qsymia came in at $232 per kg.QALYs are often used to benchmark the value of a particular health innovation, with high value interventions typically improving QALYs at a rate of $50,000 or better. “Health policy makers do not understand value in terms of cost per kilogram lost, but if you tell them that an intervention improves QALYs at better than $50K per QALY saved, they recognize that as good value for money,” Finkelstein said.

For the remaining interventions, the additional weight loss came at a price higher than what third-party payers would be likely to cover without significant cost-sharing by participants. “Although containing rising rates of obesity is a public health imperative, employers and third-party payers remain hesitant to sink big money into commercial weight loss strategies,” Finkelstein said. “But looking at cost per weight lost or QALY saved, Weight Watchers looked best because it’s the least expensive. Qsymia also showed good value for money because the additional weight loss came at a fairly low cost. To remain competitive, the other programs will either need to up the benefits and/or reduce costs, perhaps through cost-sharing or via other incentive strategies.” Finkelstein has been a paid consultant for Jenny Craig, Weight Watchers, Takeda, Orexigen, and Vivus, Inc. Kruger reporter no conflicts of interest. Data used in the quality of life analysis was obtained from a previous grant from Vivus, Inc.