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College of
Health Sciences

Center for Obesity and Metabolic Health

The Center for Obesity and Metabolic Health seeks to enhance the quality and quantity of research related to obesity within Geisinger by providing a system-wide focal point for all researchers, clinicians and trainees interested in the issues related to obesity and by establishing the necessary resources to support obesity research in epidemiology, clinical research and translational and molecular research.

A gold-standard bariatric research biobank

The Center is uniquely positioned to explore the countless benefits of surgical weight loss. Beginning in 2004, a prospective, robust bariatric registry has been supported by data from the electronic health record, patient reported results, and a vast biobank of patient samples including blood, serum, liver, adipose, stool, stomach, and jejunum. 

The registry is one of the largest and most expansive in the world, including data and samples from over 8,000 patients with excellent long-term follow-up (80% at 4-years after surgery). This bariatric research cohort is recognized globally as a gold standard for bariatric research and has been used within >80 peer reviewed research publications.

Contact Us

Colored bar.
100 N. Academy Ave.
Danville, PA 17822-2111
570-271-6709
Fax: 570-271-5201

Lead investigators:

Christopher Still, DO

Christopher Still

Lisa Bailey-Davis, DEd, RD

Lisa Bailey Davis

Peter N Benotti, MD

Peter Benotti

Diabetes risk calculator

Our team created this tool to help prediabetic patients understand their risk of developing Type 2 diabetes in the next three years.

The calculator provides personalized risk assessment and guidance to reduce your risk with weight loss. Use the app on our website.

Get-2-Goal application

Get-2-Goal is a tool created by our team to assist current, future, and prospective patients with weight management after Roux-en-Y Gastric Bypass Surgery.

Download the app here:

iOS app

Android app

Use the app on our website

How can Get-2-Goal help me?

Provides personalized weight goals using years of trends and data that have been collected by Geisinger.

•  Allows for tracking weight over time
•  Calculates probability of surviving the procedure and probability of resolving diabetes (for diabetes patients) based on information entered in your personal profile
•  For prospective patients: Displays trends of expected weight loss over time after surgery

Note: The personalized goals presented in this app are based on Geisinger research and standards. Goals may vary between hospital systems.

Areas of focus

Maternal & pediatric obesity

Our research focuses on the genetic, environmental, social and behavioral contributors to obesity.

We are re-engineering care to improve screening and risk assessment, tailoring preventive counseling, and using systems design to direct families to multi-disciplinary, treatment programs when indicated. We are training primary care providers and support staff to use motivational interviewing skills, utilizing tele-health, predictive analytics, and coordinating care between clinics and community agencies and schools to help families identify and act on solutions that make better health easier.

Our research goals include:

  • Intergenerational prevention of obesity and related chronic diseases for families 
  • Integrated framework for childhood obesity prevention and treatment across spheres of influence
  • Multi-level interventions that address biological, behavioral, environmental, economic, and policy factors
  • Implementation and dissemination research
  • Pragmatic trials and longitudinal studies
  • Patient-centered clinical decision support
  • Behavioral and environmental correlates of obesity, adiposity, fitness and metabolic-related diseases

Geisinger Collaborators:

  • Department of Population Health Sciences: Alex Chang, MD, MPH; Annemarie Hirsch, PhD, MPH; Bobbie Johannes, PhD, MPH; H. Lester Kirchner, PhD; Melissa Poulsen, PhD; Brian S. Schwartz, MD, MS; Erin Vanenkevort, PhD
  • Department of Genomic Health: Alanna Rahm, PhD
  • Steele Institute for Health Innovation: Rebecca Stametz, DEd, MPH
  • Pediatrics: Paul Bellino, MD; Pat Bruno, MD; Stacey Cummings, MD; William J. Cochran, MD (retired); Jennifer Franceschelli-Hosterman, DO; Emily Szmal, MD
  • Women’s Health, Maternal and Fetal Medicine: A. Dhanya Mackeen, MD, MPH

External Collaborators

  • The Pennsylvania State University: Jennifer Savage Williams, PhD, Department of Nutritional Sciences and Center for Childhood Obesity Research; Amy Moore, PhD, RD, Center for Childhood Obesity Research; Ian Paul, MD, MSc, Department of Pediatrics; Danielle Symons Downs, PhD, Departments of Kinesiology/Obstetrics and Gynecology; Richard Legro, MD, Department of Obstetrics and Gynecology
  • Iowa State University: Greg Welk, PhD, Department of Kinesiology

Current studies

Pragmatic Trials

ENCIRCLE Trail: PatiENt-Clinic-Community Integration to PRevent Obesity among Rural PresChooL ChildrEn Trial
PI: Lisa Bailey-Davis, DEd, RD
Funder: PCORI
Grant Number: CER-2019C1-16040
Dates: 10/2018 - 5/2025

This cluster randomized controlled trial compares three types of well-child visits for preventing obesity among preschool-aged children in rural areas. Participants are children aged 2-5 years and their families who receive an annual well-child visit at Geisinger. To learn more about the study see https://www.pcori.org/research-results/2019/comparing-three-types-well-child-visits-preventing-obesity-among-preschool-aged-children-rural-areas

Contact Us: encircle@geisinger.edu or 866-207-9289, option 2

Reversing Metabolic Syndrome: Eat, Love, Move: A multi-site Randomized Controlled Trial
PI: Lisa Bailey-Davis, DEd, RD
Funder: William G. McGowan Charitable Fund
Grant Number: CER-2019C1-16040
Dates: 10/2018 - 9/2024

This is a multi-site randomized controlled trial of a lifestyle intervention designed to reverse metabolic syndrome. The project enrolled 600 persons with metabolic syndrome at 5 sites across the US including Geisinger. Learn more at www.elmtrial.org.
Contact Us: ELM@geisinger.edu or 866-630-0798, option 2

ENRICH
Site PI: Lisa Bailey-Davis, DEd, RD
Funder: National Institutes of Health
Grant Number: IUG3HL162971
Dates: 5/2022 – 3/2029

The Early Intervention to Promote Cardiovascular Health of Mothers and Children multicenter trial aims to test the effectiveness of an intervention designed to promote cardiovascular health and address cardiovascular disparities in both mothers and children (0-5 years old).  ENRICH is funded by the National Heart, Lung and Blood Institute in collaboration with several federal partners. Geisinger is part of the Penn State Clinical Center, one of seven clinical centers in the trial. Learn more at www.hvenrich.org.
Contact Us: enrich@geisinger.edu or 570-214-1424

Longitudinal Cohort Studies

Central Pennsylvania Rural Birth Cohort
PI: Lisa Bailey-Davis, DEd, RD
Dates: 2022 – present

This is a collaborative prospective longitudinal pilot study between Geisinger and The Pennsylvania State University (Penn State) to determine what strategies are most successful: 1) in building and retaining a cohort of families from rural communities in Central Pennsylvania with recruitment beginning in pregnancy, infant/toddler age, and preschool age using a cohort sequential design; 2) for collecting Geisinger clinical electronic health record (EHR) and remote biobehavioral measurements (Penn State) to better characterize synergistic factors associated with obesity and substance use in this population; and 3) for identifying points for future intervention, treatment, prevention, and policy efforts to reduce health disparities in maternal-child morbidity and promote positive family processes. 

Child and Adolescent Trend (CAT) Data Registry 
PI: Lisa Bailey-Davis, DEd, RD 
Dates: 2022 – present

The Childhood and Adolescent Trend (CAT) data registry includes a subset of the Geisinger electronic health record (EHR) and collects data on 542,211 Geisinger patients with a pediatric BMI measured with a same day height and weight at age 20 years or younger between 1982 and 2022 (refreshed annually or on-demand).  In August 2022, the CAT cohort had a median age of 18 years (min 0 years, max 45 years, mean: 18.32 years) with 5.1 million height/weight measurements (median age @ measurement 7 years; mean age @ measurement 7.95 years; median of 5 measurements and mean of 9.4 measurements). 

The CAT registry is a collection of EHR data (demographics, vitals, encounters with diagnosis, problem list diagnosis, labs, social history, medication history, and referrals) as well as custom data including adult BMI, CDC and WHO BMI percentiles, BMI Extended, Family Nutrition and Physical Activity (FNPA) and Early Healthy Lifestyles (EHL) behavior and home environment data, food insecurity, and youth Blood Pressure Percentiles. 

PREVENT 
PI: Lisa Bailey-Davis, DEd, RD
Dates: 2013 – present
The goal of this prospective, longitudinal cohort study is to determine if the pediatric care redesign with evidence-based screening (using the Family Nutrition and Physical Activity, FNPA, tool), patient-centered education, negotiated decision-making and health information technology to reverse childhood obesity clinical improvement initiative is improving the quality of care by examining process and outcome measures associated with parent-child exposure to PREVENT. 

FNPA is collected as a patient-reported outcome measure at annual well-child visits for children aged 2 to 9 years (2013-2019), 2 to 12 years (2020-present) and 2-17 years (beginning 2024).  A study-developed tool, Early Healthy Lifestyles (EHL) is used to collect parenting practices and child eating, sleeping, and activity data from parents/caregivers aged 0-26 months at routine well-child visits (2013-present). Findings from this longitudinal study are used to continuously improve the value of and quality of care for the primary prevention of pediatric obesity and related comorbidities. Our team collaborates with National FNPA Leaders (myfnpa.org) to facilitate dissemination and implementation of the tool to clinical sites globally.

Community Engagement

UNITY
PI: Lisa Bailey-Davis, DEd, RD
Funder: The Degenstein Foundation
Dates: 12/2022 – 12/2024

This project engages community partners in 5 central Pennsylvania counties for an Upstream Planning Initiative to Improve Response to Child Maltreatment.  Community-engaged planning is focused on identifying solutions that will alter the health trajectories for patients and families affected by or at risk for child maltreatment.  
Contact Us:unity@geisinger.edu or 866-630-0798, option 2

PaTH MOMS: Establishing a PCORnet PaTH Clinical Research Network Maternal Morbidity and Mortality Patient Stakeholder Council
Site PI: Lisa Bailey-Davis, DEd, RD
Funder: PCORI®
Dates: 7/2023 – 6/2025

The project aims to create a Council of patients with maternal health lived experiences, maternal health clinicians and researchers, and maternal health community partners guided by a shared vision to improve maternal outcomes for patients of racial and ethnic minorities and rural residency. The project will support the development of capacity building activities needed to create a Council that can effectively inform the development of an equitable and inclusive PCOR/CER research agenda in maternal health.

 
Adult obesity

Preventing Diabetes
This project aims to prevent diabetes among a high-risk patient population with pre-diabetes. Efficacious treatments for weight management exist but are rarely discussed in primary care. Our project addresses a gap in care by making existing clinical tools easily available to primary care providers through training, electronic health record prompts, clinical decision support tools, and patient activation strategies. 

In collaboration with their physician, patients choose a weight management program that best meets their needs and lifestyle with an understanding of expected outcomes. This project puts risk, treatment, and predicted outcome information at the fingertips of patients and physicians and will result in an improved patient experience, increased demand for weight management discussions, improved quality of care, and prevention of diabetes through modest weight loss.

Geisinger Rural Aging Study
The Geisinger Rural Aging Study (GRAS) began in 1994 with more than 20,000 participants age 65 and older.  The participants live in communities in rural northeastern and central Pennsylvania. Their health and nutrition has been followed over time, providing a means to study nutrition and aging. 

Clinical trials
Our team of Clinical Research Coordinators, Project Managers, Project Coordinators, and Research Assistants have extensive experience in conducting phase II and III intent-to-treat and cardiovascular outcome clinical trials in the therapeutic areas of non-alcoholic steatohepatitis, weight management, and metabolic syndrome.

The Center for Obesity and Metabolic Research is embedded within Geisinger’s Weight Management Clinic with providers experienced in all current treatments for obesity including lifestyle management and pharmacotherapy.

Bariatric surgery

Geisinger collaborators:

External collaborators:

  • Dr. Gorden Jensen, University of Vermont
  • Dr. Glenn Gerhard, Temple University
  • Dr. Manish Parikh, NYU Bellevue
  • Dr. David Rovnyak, Bucknell University
  • Dr. Chiadi Ndumele, Johns Hopkins University

Current studies

SWIFT
Obese patients pursuing a TKA procedure are typically encouraged to lose weight prior to the procedure as part of the patient's treatment plan. If the patient chooses to receive treatment for his or her obesity, the Orthopedic provider may refer the patient to a weight management provider. If a patient is eligible for TKA and meets the inclusion and exclusion criteria (containing BMI and corresponding comorbidity measures), he/she is eligible to participate in the study.

In this study there will be two arms, a Test Arm in which patients undergo bariatric surgery prior to TKA and a Control Arm in which patients undergo TKA only. Patients will choose which arm they enter, based on whether or not they want to undergo surgical weight loss intervention prior to TKA.

The study hypothesis is that weight loss induced by bariatric surgery prior to TKA will improve TKA outcomes in patients with extreme obesity. The study hypothesis will be met if one of the following outcomes is achieved:

  1. In >=20% of bariatric surgery patients, the need for TKA was negated or delayed for at least two years.
  • A statistically significant superiority is found among those patients undergoing bariatric surgery + TKA versus those undergoing TKA only in at least two of the following domains at two years post TKA:
  • Mobility (400 meter walk test)
  • Osteoarthritis outcome (WOMAC total score)
  • Knee orthopedic outcome (Knee Society score)
  • Quality of life (PROMIS-29 Quality of Life Questionnaire)
  • Osteoarthritic Pain (KOOS Pain)
  • Patient Satisfaction (If you had to live the rest of your life with the symptoms you have now, how would you feel?)

PCORI Bariatric Study
The PCORI Bariatric Study is a comparative effectiveness research study to provide accurate estimates of the 1, 3, 5- year benefits and risks of the three main surgical treatment options for the severe obesity. The three main surgical treatments include roux-en-y gastric bypass (RYGB), adjustable gastric banding (AGB) and sleeve gastrectomy (SG). The study includes adults, children, and adolescents less than 80 years old at time of surgery who had one of the three most common procedures (RYGB, AGB, or SG) and all patients also have a Body Mass Index (BMI) measurement in the year prior to surgery that is at least 35 kg/m2.
The three factors that will be studied are:

  • to what extent weight is lost and regained
  • improvement in diabetes
  • risk of adverse events occurring in the three different surgical treatment options

NASH/NAFLD RNAseq
There is a large unmet need in chronic liver disease research including NAFLD/NASH. This project is conducted in collaboration with Regeneron Pharmaceuticals. The goal of this research program is to understand the interplay between DNA sequence variation, gene expression and isoform use, and clinical phenotypes related to obesity and chronic liver disease by using:

  • transcriptomic profiling of liver and adipose tissue, coupled to array DNA genotyping and whole exome sequencing
  • clinical phenotypes captured in electronic health records (EHRs)
  • other data streams

In understanding putatively causal relationships among these molecular intermediates and clinical outcomes captured in EHRs, we hope to elucidate novel biology relevant to the identification of novel therapeutic targets for chronic liver diseases. The creation of a comprehensive, durable resource of deep functional genomics data, coupled to one of the most well-characterized populations with morbid obesity yet assembled, will empower additional investigations of the molecular basis of obesity-related phenotypes.
Bariatric Database and Biobank

Beginning in 2004, a prospective, robust bariatric registry has been supported by data from the electronic health record, patient reported results, and a vast biobank of patient samples including blood, serum, liver, adipose, stool, stomach, and jejunum. The registry is one of the largest and most expansive in the world, including data and samples from over 8,000 patients with excellent long-term follow-up (80% at 4-years after surgery). This is recognized globally as a gold standard for bariatric research and has been used within >80 peer reviewed research publications.

 
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