If you are struggling with obesity and its associated health problems, including type 2 diabetes, sleep apnea and hypertension, weight loss through traditional means can be a challenge. Bariatric surgery can help you effectively lose weight, get healthy and regain your life. HealthONE’s network of care includes five specialized weight loss surgery centers – located in the Denver area: North Suburban Medical Center Presbyterian/St. Luke’s Medical Center Sky Ridge Medical Center Four of these centers have been designated as Centers of Excellence. As a HealthONE patient, you have access to highly experienced surgical teams and weight loss doctors who maintain the top standards of care. Our board-certified surgeons perform more bariatric procedures than any other health system in Colorado. HealthONE’s Bariatric Care network is one of the nation’s leading centers for weight loss surgery, performing more than 1,000 traditional procedures every year.

Adjustable gastric banding (Lap® Band) At HealthONE, you also have access to some of the most advanced and innovative bariatric procedures for weight loss. As a bariatric patient in the HealthONE network of care, you will receive support at every stage of your weight loss journey. Informational seminars, where you can learn about surgical options and what to expect as a patient. Medical weight loss programs if you are required by your insurance provider to participate in a weight loss program prior to surgery. Support groups and post-op classes, in which you can learn how to maintain a healthy weight post-surgery. Specialized facilities designed to create a comfortable environment when you undergo weight loss surgery. Text Messaging for Weight Loss Behavioral: Text Message Based Weight Loss Support Allocation: RandomizedEndpoint Classification: Efficacy StudyIntervention Model: Parallel AssignmentMasking: Open LabelPrimary Purpose: Health Services Research

The Comparative Effectiveness of Clinic-Based Weight Loss Strategies Absolute weight loss in pounds [ Time Frame: 12 months ] [ Designated as safety issue: No ] Percent weight loss [ Time Frame: 12 months ] [ Designated as safety issue: No ] Change in glycemic control as measured by HbA1c and fasting glucose [ Time Frame: 12 months ] [ Designated as safety issue: No ]How To Cut Your T Shirt Like A Rockstar Patient Engagement Measures [ Time Frame: 12 months ] [ Designated as safety issue: No ]Over Bath Fixed Shower Screens Percent of patients who maintain or lose weight [ Time Frame: 12 months ] [ Designated as safety issue: No ]Better Homes And Gardens Our Best Desserts

Changes in systolic and diastolic blood pressure [ Time Frame: 12 months ] [ Designated as safety issue: No ] Change in LDL-cholesterol [ Time Frame: 12 months ] [ Designated as safety issue: No ] Operating costs per participant receiving intervention [ Time Frame: 12 months ] [ Designated as safety issue: No ] May 2015 (Final data collection date for primary outcome measure) No Intervention: Usual Care for Weight Loss Experimental: Text Message Based Weight Loss Support Text messaging has been shown to be effective for weight-loss in very limited testing. DH has experience with both text message based intervention and weight management intervention. This study aims to enhance Denver Health's (DH) existing Patient Relationship Management (PRM) text message (SMS) infrastructure to include culturally-appropriate outreach to promote weight loss. Subjects will be randomized into one of two arms: Usual care: Patients randomized to this arm will not receive text messages or any other weight-loss support besides usual care provided at DH.

They will receive a weight loss educational packet and be asked to follow up with their primary care provider to further discuss their efforts at weight loss with additional follow-up as directed by their provider. They will be contacted periodically to be weighed. Providers will not be made aware that their patients are participating in the study's control arm. Text Message-based weight loss support. Patients will receive the same weight loss educational packet as those randomized to usual care. Patients will be assisted in choosing a self-management goal related to exercise and to eating behaviors. They will receive text messages at a frequency up to 1x daily; input from focus groups will guide text message frequency. SMS content is similar to the Diabetes Prevention Program (DPP) curriculum and will fall into the following categories: Outgoing "tips of the day" Interactive messages that solicit a simple response for the day from the participant Outgoing reminders to inform participant about events in the community and about clinic appointments with their primary care provider.

Basic descriptive statistics for categorical variables will be generated to describe the baseline demographic and clinical characteristics. Univariate analyses will be performed to determine whether there are differences between patients in the three arms of the intervention. For clinical outcomes, general linear mixed effects models will be used with intervention and time (and their interactions) specified as fixed effects to determine whether change over time in outcomes differs significantly for the three groups. A random subject effect will be specified to model the correlation of observations taken on an individual. Contrasts will be constructed to test the difference in interventions at six months and 12 months. If the data do not follow an approximate normal distribution or cannot be normalized using log transformation the ranks of the outcomes will be analyzed in the mixed effects model. All statistical analyses will be performed using Statistical Analysis Software (SAS) version 9.2.

The study is powered to detect a difference at six months between the text message group and the usual care group. Previous research suggests that, with 60 participants per group, researchers would have 89% power to detect a difference between groups of 1.7 kg. The investigators think that this is a reasonable estimate, as subjects in the control group in this study lost 0.4 kg, and it is believed that subjects in the control group will be weight stable. While investigators anticipate that patients who participate in the DPP program will lose weight, it is believed participation across the usual care and SMS groups will be comparable as i) randomization is stratified to the two groups by past participation in the DPP and ii) relatively equal participation in the two groups is anticipated throughout the intervention period. This stratification is intended to equalize the effects of class-attendance heterogeneity across the two study groups. The study aims to have 90 participants per group to improve the power for sub-group analyses.

Ages Eligible for Study: 18 Years and older   (Adult, Senior) Genders Eligible for Study: ≥ 18 years of age or older Ownership of a cell phone with SMS capabilities HbA1c greater than 5.6 but less than 6.5 BMI ≥ 25 kg/m2 and less than 50 kg/m2 English or Spanish speakers. Individuals with co-morbid illness with life expectancy less than 12 months (e.g., terminal cancer, Child's Class C hepatic cirrhosis) Diabetes based on an ICD-9 code in previous 3 years Individuals not planning to stay in the area at least 6 months. Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies. Please refer to this study by its ClinicalTrials.gov identifier: NCT02063048