Nurse Practitioner Led Low-Calorie Ketogenic Diet for Weight Loss in Overweight and Obese Adults

Objective: To evaluate the relationship of a primary care weight loss intervention of low- calorie ketogenic diet (LCKD) led by a Nurse Practitioner (NP) for overweight and obese adults and to evaluate if LCKD has weight loss, BMI reductions and decreases in percent body fat correlations to age and gender. Finally, this project aims to study if an NP led LCKD program has similar results to a physician lead program with similar design. Background: Obesity is being recognized as the new global pandemic with a significant comorbid and economic impacts to the healthcare system. Primary care is the first place that patients seek healthcare and as such the literature supports the need for primary care treatment options for all overweight and obese patients. Currently no formal guidelines exist to treat the overweight and obese and current interventions have had minimal success. A gap exists in the evaluation of NP led interventions in the management of overweight and obesity as primary care providers. Design: There were 368 subjects, 314 females and 54 males, who met eligibility criteria of at least 18 years of age with a BMI >25 kg/m² following an NP led LCKD who were evaluated for weight loss along with BMI reduction and changes in percent body fat. Correlations were analyzed to age and gender. Results of weight loss with NP program were compared to two physician led studies of similar design to compare results. Results: Statistically significant (p<0.05) reductions in weight loss, body mass index (BMI) and percent fat loss were noted at all intervals with total weight loss after 12 weeks. Males lost slightly more weight than females with a difference of 0.86% greater weight loss. The greatest weight loss occurred between ages 45-54 years however, there were no statistical differences in weight loss between age groups. Case analysis comparison with two physician led studies showed that the NP led study found more weight loss in one case but not the other. Conclusion: The NP led LCKD is a potentially effective weight loss option in primary care for both genders and all ages. Further prospective study is needed to determine the NP specific interventions that impact overweight and obesity implemented by the NP in primary care.