Name of the Procedure:

Achieving 9% Weight Loss Under the MDPP Expanded Model

Common Name(s):

• Weight Loss Achievement Under MDPP
• 9% Weight Loss Milestone (G9881)

Technical or Medical Terms:

• MDPP (Medicare Diabetes Prevention Program)
• MDPP Expanded Model (EM)
• HCPCS G9881

Summary

This is a milestone in a structured weight loss program where a beneficiary achieves a significant weight reduction of at least 9% from their baseline weight within the first 24 months. This milestone is recognized under the Medicare Diabetes Prevention Program (MDPP) and is a one-time payment when this weight loss is first achieved.

Purpose

Medical Conditions or Problems it Addresses:

• Prediabetes
• High risk for Type 2 diabetes
• Overweight and obesity

Goals or Expected Outcomes:

• Reduced risk of developing Type 2 diabetes
• Improved overall health and wellness
• Achievement of sustained weight loss

Indications

Specific Symptoms or Conditions:

• Diagnosed prediabetes
• BMI indicating overweight or obesity
• Referral from healthcare provider based on risk factors for diabetes

Patient Criteria:

• Participation in the MDPP expanded model
• Continuous engagement in the weight management sessions

Preparation

Pre-procedure Instructions:

• Regular attendance to behavioral counseling sessions
• Dietary and physical activity modifications as per the program guidelines
• Regular self-monitoring of weight

Any Diagnostic Tests or Assessments:

• Initial weight assessment
• Periodic weight check-ins to track progress

Procedure Description

Step-by-Step Explanation:

1. Enrollment in the MDPP expanded model program.
2. Attendance in a series of 16 intensive core sessions focusing on diet, exercise, and behavior change over the first 6 months.
3. Continued participation in monthly maintenance sessions for at least 6 months.
4. Achieving a weight loss of at least 9% of baseline weight by months 1-24.

Tools, Equipment, or Technology:

• Regular scales for weight measurement
• Educational materials for lifestyle changes
• Tracking tools or apps for monitoring progress

Anesthesia or Sedation:

• Not applicable

Duration

• The program spans 24 months with the 9% weight loss achievement ideally within this period.

Setting

• Outpatient settings, including community health programs, wellness centers, or virtual settings.

Personnel

• Lifestyle coaches
• Dietitians
• Program coordinators
• Healthcare providers for continuous supervision and support

Risks and Complications

Common Risks:

• None directly related to the weight loss milestone itself.

Possible Complications:

• Plateaus in weight loss progress
• Potential relapse without continuous support
• Rare nutritional deficiencies if dietary changes are not balanced

Benefits

Expected Benefits:

• Significant reduction in the risk of developing Type 2 diabetes
• Enhanced physical health and reduction in other obesity-related conditions
• Improved mental health and self-efficacy

Realization of Benefits:

• Benefits observed continuously as the program progresses and weight loss is maintained.

Recovery

Post-procedure Care:

• Ongoing participation in maintenance sessions
• Continuation of lifestyle changes

Expected Recovery Time:

• Not applicable as this is a milestone rather than an invasive procedure.

Any Restrictions or Follow-up:

• Continuous engagement with the program to prevent weight regain.

Alternatives

Other Treatment Options:

• Traditional weight loss programs (commercial or healthcare-based)
• Bariatric surgery for qualifying patients
• Pharmacotherapy for weight loss

Pros and Cons of Alternatives:

• Traditional programs may not offer the same structured, long-term support.
• Bariatric surgery involves significant risks and longer recovery period.
• Pharmacotherapy may have side effects and requires medical supervision.

Patient Experience

During the Procedure:

• Regular interaction and support from lifestyle coaches.
• Engagement in supportive group sessions or one-on-one counseling.

After the Procedure:

• Sense of achievement upon milestone completion.
• Potential lifestyle adjustments to maintain weight loss.
• Pain management and comfort not typically applicable as the milestone achievement involves gradual behavior modification rather than a conventional medical procedure.