Go for Bold: Improving Outcomes One Pound at a Time

ABSTRACT

In an effort to improve overall community health, in 2020, Meritus Health established an ambitious goal: engage individuals in Washington County, Maryland, to collectively lose 1 million lb by 2030. The goal acknowledges obesity as a significant population health challenge. and the goal is a way to unify the community. Goal implementation focused on leveraging existing resources, building partnerships, and engaging community members. Meritus collaborated with schools, employers, and government entities through its local health improvement coalition, Healthy Washington County. The campaign, launched in October 2020 as “Go for Bold,” promotes 3 strategies: increasing physical activity, adopting a balanced diet, and improving mental well-being. The campaign introduced a web-based weight tracker that allows users to enter their weight in a confidential account that records pounds lost over time. As of December 2024, more than 160,000 lb have been lost, with participation from 55 community partners and more than 7700 individuals. From 2020 to 2024, individuals have become healthier, reflected by a 6.05% increase in Meritus endocrinology patients achieving a body mass index of less than 27 and a 2.3% rise in Meritus patients overall meeting this target. Along the way, Meritus has learned several valuable lessons. First, setting a bold, measurable goal helps build a sense of shared purpose. Second, utilizing preexisting resources ensures sustainability. Next, engaging the community with strategic events and celebrations fosters sustained participation. The success of the Go for Bold campaign provides a replicable framework for others seeking to implement similar initiatives to advance population health in their communities.

Am J Manag Care. 2026;32(Spec. No. 3):SP148-SP152. https://doi.org/10.37765/ajmc.2026.89903

Addressing population health challenges on a large scale can be very complex and has many unseen barriers. One pervasive health challenge includes obesity and diabetes as significant contributors to chronic health conditions and poor outcomes, including hypertension, high cholesterol, stroke, and depression.¹ The increasing prevalence of these issues has also placed severe strain on health care resources and community well-being, with an annual estimated cost of $412.9 million for diagnosed diabetes in 2022.²

Within Washington County, Maryland, a 2019 community health needs assessment (CHNA) identified that more than 33% of the adult population had obesity (body mass index [BMI] ≥ 30) and 11.3% had been diagnosed with diabetes. The CHNA also demonstrated concerning demographic trends, such as 12.2% of the county living in poverty, a decreasing life expectancy due to increasing suicide rates and drug overdose fatalities, fewer college graduates compared with the rest of the state, and a quickly growing older population. Some of the health challenges mentioned by the community included an increasing rate of physical inactivity, a shortage of available primary care physicians, and a need for more information on diet, nutrition, weight loss, and healthy lifestyle changes.³ Washington County has a population of 155,000 people in a mix of rural, urban, and suburban settings, and Hagerstown, the county seat, is less than 1.5 hours’ drive time from Baltimore and Washington, DC.

In response to the issues presented in the CHNA, regional care provider Meritus Health launched an ambitious initiative in 2020, as part of its 2030 Bold Goals campaign, to help the community collectively lose 1 million lb by 2030. The initiative was titled “Go for Bold,” and achieving this goal required Meritus to accurately collect data, set measurable goals and milestones, leverage existing partnerships, and build community engagement. With less than 5 years until 2030, Meritus faces the challenges of increasing momentum, scaling efforts to reach this goal, and closing the gap on the 800,000-plus remaining lb. By working to overcome these challenges, Meritus has built a replicable model for others seeking to tackle similar population health issues in their communities.

Goal

In 2020, Meritus Health aimed to improve the health of Washington County by encouraging members of the community, businesses, and local organizations to collectively lose 1 million lb by 2030. This goal reflects Meritus Health’s response to the significant population health crisis caused by obesity and diabetes and the need for an ambitious goal to unify the community behind this initiative.

Execution

Meritus Health’s journey to develop a community-wide population health initiative began in 2019, when a bold health goal was added to the strategic plan. The first pivotal stakeholder meeting occurred on January 18, 2020, when Meritus Health gathered 30 community members for strategic planning. The group reviewed health priorities identified in the CHNA and brainstormed goals that would have the greatest impact on prevalent health challenges, including obesity, suicide, addiction, diabetes, and hypertension. After the COVID-19 pandemic, upon viewing a video about a successful obesity reduction initiative in Oklahoma City, Oklahoma, the team was inspired to unite Washington County, the surrounding region, and Meritus Health employees around a shared bold goal: for the community to lose a collective 1 million lb by 2030.⁴

Under the title Go for Bold, this vision would be carried forward in partnership with Healthy Washington County, a local health improvement coalition. Announcing this goal energized participants, sparking enthusiastic support for the endeavor. By March 2020, a framework for the 10-year campaign was completed, and the weight-tracking app was finalized. The Weight Tracker allows participants to enter their starting weight and track progress toward their personal weight loss goals. When logging individual pounds lost, the Weight Tracker calculates cumulative pounds lost across the community. The breakdown of the top company partners as of December 2024 includes Meritus Health with 3333 registered users and 70,011 lb lost, CoreLife with 777 users and 25,367 lb lost, Brook Lane Health Services with 204 users and 2263 lb lost, and Volvo Group Trucks with 287 users and 2349 lb lost. It is important to note that some participants have formed groups and measure their weight loss collectively as one user. By tracking weight loss at their company and participating in the campaign as a team, users are motivated to engage further, as studies have shown that teammates positively influence weight loss during team-based interventions.⁵ Overall, the tracker serves as both a personal accountability tool and a measurement of goal achievement.

After a delay due to COVID-19, the initiative was formally launched on October 6, 2020, with a campaign of pledges from local organizations that committed to weight loss pledges over the next 10 years. “Go for Bold!” became both the challenge and the official campaign name. Go for Bold focuses on 3 core pillars: increasing physical activity (Do), adopting a nutritious diet (Eat), and fostering mental well-being (Believe). The web-based Weight Tracker, linked to the Healthy Washington County website, allows participants to enroll, log their weight weekly, and monitor their progress. The website is linked to community activities and vetted health resources, including fitness plans, nutritional advice, mindfulness, and mental health support.

Initial funding was provided through Meritus Health’s community benefit, which directed time and resources toward developing the campaign’s infrastructure. Within 30 days, the Weight Tracker began using the data to calculate pounds lost. Throughout 2021, Meritus Health and its partners refined the campaign by sharing monthly feedback data with participants, including total pounds lost, the number of participants, and the organization’s progress toward meeting its pledged goal. These metrics helped secure grant funding and sustained the initiative. At the year 1 milestone, a planned in-person event on September 7, 2021, to celebrate success was conducted virtually due to a spike in COVID-19–related illness in the community. During the event, 8 organizations were recognized as leaders with a cumulative community weight loss of 21,837 lb. The Figure shows the annual cumulative weight loss and number of registered users for the Go for Bold program from 2020 to 2024.

In 2022, Meritus Health integrated the initiative into its employee wellness plan, offering reduced medical insurance premium contributions for employees who enrolled and weighed in, resulting in higher engagement. The strategy served as a model for how other organizations could align their wellness incentives with the campaign. Additionally, local businesses and schools created friendly competitions, such as weight loss challenges, that spurred further involvement. Individual stories and testimonials were shared on the website, highlighting people who achieved success using the program.

Two years in, the initiative had gained substantial traction across the community. Meritus Health and its partners hosted an annual Go for Bold event to recognize achievement, share best practices, and celebrate success. At the 2022 annual event to celebrate milestones and recognize participants, Mick Cornett, who had overseen a million-lb weight loss initiative when he was mayor of Oklahoma City, was invited to share insights and lessons learned. The event energized stakeholders and underscored the potential of the Go for Bold campaign.

Through 2023, the campaign continued to evolve, providing new promotional materials, including a QR code linked to registration, window clings to increase awareness, and educational videos to support lifestyle changes centered on “Do, Eat, Believe.” Community organization participation increased to more than 50 employers, with new partnerships featuring health and fitness organizations.The annual event featured state officials and celebrated the milestone of 100,000 lb lost.

Momentum continues to be sustained. Meritus Health continues to leverage its existing resources, such as health expertise, community partnerships, and healthy activities, to keep participants motivated and engaged. As of December 2024, there were more than 7720 participants and a community weight loss of more than 160,000 lb.

Since its inception, this initiative has demonstrated a tangible impact on the health, as reflected in the Table, which highlights improvements in BMI outcomes from 2020 to 2024 among Meritus Health patients. Although BMI was the primary measurement in this analysis, it’s important to note that achieving a healthier BMI is often accompanied by reduced chronic disease complications, improved mental health, and an increase in quality of life.⁶ Among the 32,108 Meritus Health patients with annual BMI measurements from 2020 to 2024, the proportion with a BMI less than 27 increased by 1.36%, corresponding to 436 individuals achieving this threshold. In the broader population of patients with at least 1 BMI measurement per year—99,586 patients in 2020 and 123,384 patients in 2024—the proportion meeting the BMI benchmark increased by 2.3% over the same period, representing approximately 2300 patients. These metrics were also examined in Meritus Health endocrinology patients specifically. Among the 824 patients with annual endocrinology visits from 2020 to 2024, the proportion achieving a BMI less than 27 increased by 5.95%. In the broader population of patients with an annual endocrinology visit—1886 patients in 2020 and 4699 patients in 2024—the proportion achieving a BMI less than 27 increased by 6.05% over the same period, representing 195 individuals. These outcomes highlight the tremendous initial impact of the Go for Bold initiative on improving the health of Washington County.

Hurdles and Limitations

Although the Go for Bold initiative has made significant strides, the journey was not without its challenges. Several hurdles arose throughout the execution phase that required constant attention and adaptation.

The Weight Tracker has several limitations, including that it only captures pounds lost, so individuals’ weight gain during participation is not reflected in the system. This means that regained pounds, if lost again, are counted multiple times. Additionally, no demographic data are collected, limiting analysis of the program’s effectiveness across demographic groups. Acknowledging the gaps that account for weight fluctuations and equity remains part of a broader health journey for both participants and Meritus Health.

Confidentiality concerns also pose barriers to participation, despite assurances that data are used exclusively for the initiative. Overcoming these concerns requires continued communication and transparency to build trust with potential participants.

Sustaining long-term engagement remains a hurdle that requires constant reinforcement, recognition, and involvement to maintain participation rates. The team recognizes that the effort to lose 1 million lb is not a one-time sprint but a long-term commitment to providing the resources necessary to continue motivation and engagement.

Although BMI outcomes of Meritus Health patients have improved, weight loss cannot be attributed solely to the program, considering that glucagon-like peptide-1 receptor agonist (GLP-1 RA) prescription volumes began to skyrocket in late 2022. Although medication likely impacted the initiative’s outcomes, the Go for Bold program plays a role in behavioral and social reinforcement of healthy living. This is evident through the almost 40,000 lb lost by July 2022, before the spike in GLP-1 RA usage. Causality of the program’s BMI improvements is multifactorial, and it is understood that no single intervention works for everyone.

Lastly, the focus on weight loss itself was a point of contention. Concerns were expressed about the potential stigma associated with the emphasis on weight loss, particularly for those unable to achieve significant weight loss goals and those with eating disorders. The challenge of addressing this stigma while encouraging healthful behaviors without promoting harmful body image ideals required messaging with sensitivity to the diverse experiences of all community members. Although the highlighted outcome is measured by pounds lost, the overall health benefits, including a better diet, regular physical activity, improved mood, and stress management, are so much greater. The campaign uses inclusive language, avoids harmful “ideal body type” content, and highlights success stories from a diverse set of participants. The program emphasizes making progress toward wellness and health over perfection.

Despite these hurdles, Meritus Health and its partners have continued to refine the initiative, using feedback to make strategic adjustments and ensuring that the Go for Bold campaign remains a sustained and meaningful effort to improve the health of Washington County.

Conclusions

As Meritus Health reflects on the significant impact the Go for Bold program has had so far, it is important to consider what the future holds. The program does not collect participant-level demographic data, such as race, ethnicity, income, or geographic distribution, which limits the ability to evaluate its reach and equity outcomes. In recognition of this, subsequent iterations of this campaign will explore additions to the Weight Tracker platform to allow for confidential demographic reporting. This will help Meritus Health identify and address any disparities in reach or outcomes through targeted outreach or updates to the program. Additionally, the Go for Bold initiative could be relevant to future policy initiatives. Characteristics of the program, such as cross-sector collaboration, community-based goal setting, and wellness incentive integration, make this a replicable framework for local- or state-level health planning. In the future, the lessons learned from implementing this program can be shared to inform policy briefs, legislation, and local health initiatives in rural-urban regions.

The success of the Go for Bold campaign stands as a testament to the power of community collaboration, strategic partnerships, and clear, measurable goals. Through the efforts of Meritus Health, Healthy Washington County, and the broader community, this initiative has set a powerful example of how a localized health campaign can spark a widespread movement toward better population health outcomes.

Author Affiliations: Meritus Health (RP, AT, MSJ), Hagerstown, MD.

Source of Funding: None.

Author Disclosures: The authors report no relationship or financial interest with any entity that would pose a conflict of interest with the subject matter of this article.

Authorship Information: Concept and design (RP, AT, MSJ); acquisition of data (RP, MSJ); analysis and interpretation of data (RP, AT, MSJ); drafting of the manuscript (RP, AT); critical revision of the manuscript for important intellectual content (RP, AT, MSJ); statistical analysis (MSJ); and administrative, technical, or logistic support (RP).

Send Correspondence to: Remi Patel, MHA, Meritus Health, 11116 Medical Campus Rd, Hagerstown, MD 21742. Email: remi.patel@meritushealth.com.

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