Rural Engagement in TelemedTeam for Options in Obesity Treatment Solutions

The purpose of this study is to compare two methods for managing obesity in rural primary care patients. The first method includes quarterly 1:1 meetings with the participant and their primary care provider and the second includes a group lifestyle intervention over Zoom paired with quarterly team meetings with the participant, their primary care provider and their lifestyle coach, the coach joining via Zoom. Investigators will evaluate which method is best at helping participants lose weight over 18 months.

Inclusion Criteria:BMI: >= 30 kg/m2Rural residentEnglish speakingPhysician clearance to participateAble to walk without assistanceSeen at least once in their primary care clinic within the past yearInternet access or smart phone (to access smart scale for weight measurement)Exclusion Criteria:History of myocardial infarction within last six monthsHistory of stroke within last six monthsHistory of new cancer diagnosis within last six monthsHistory of bariatric surgery within the last two yearsPregnancy within last 6 months or planned within the next 18 monthsCurrently breastfeedingEnd stage renal disease, currently on dialysis, or anticipated dialysis or renal transplant within the next 18 monthsEnd stage liver disease, or anticipated liver transplant within the next 18 monthsCurrently enrolled or planning to enroll in another study where weight loss is targeted or weight fluctuation is expectedCurrently planning to move outside of current provider area, or leave primary care clinic within the next 18 monthsAnother household member is already participating in the study