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Doctors Must Help Patients Lose Weight, Say New Recommendations
In order to provide the best care, doctors should refer overweight patients to nutritionists and other healthcare professionals who can help them drop pounds, according to new guidelines on obesity.
By Susan E. Matthews
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TUESDAY, November 12, 2013 —With obesity numbers constantly on the rise as the public health epidemic looms, several groups of doctors have developed guidelines to help overweight and obese patients. These new guidelines are designed to educate doctors on specific ways they can help patients , rather than just tell them they must.
Coauthored by the American Heart Association, the American College of Cardiology, and the Obesity Society, these new guidelines are published today in three journals: Circulation, the Journal of the American College of Cardiology, and Obesity: Journal of The Obesity Society.
“Most physicians were never trained in weight loss, they had training in hypertension and diabetes and cholesterol,” said Tim Church, MD, MPH, PhD, director of the laboratory of preventive medicine at Pennington Biomedical Research Center in Baton Rouge, Louisiana. With new research coming to light about what makes weight loss efforts successful, it was time to reform the guidelines, Church said. Nearly half of the adult population — 155 million adults — are overweight or obese, and these guidelines aim to help patients address the issue better.
Doctors are advised to measure their patients’ body mass index (BMI) and waist circumference more frequently. They are also asked to to take a more supportive role in helping patients lose weight: Instead of simply encouraging exercise and healthy diet, doctors are being asked to take a more active role in finding nutritionists, weight loss groups, or therapists for overweight and obese patients.
Getting the patient in touch with the proper support network is the most critical factor in starting the weight loss process, said Scott Drab, PharmD, CDE, associate professor of pharmacy and therapeutics at the University of Pittsburgh School of Pharmacy.
“The typical response from a doctor is to emphasize that ‘you need to lose weight,’” said Drab. “It’s never ‘How can I help you to lose weight?’, even though that would be a much more effective strategy."
Currently, it’s difficult for doctors to bring up the subject of weight because there’s not enough time in an appointment to really address the underlying problems that may be the root of the excessive weight, Church said. It tends to be an emotional issue, and can be particularly tough if the doctor is overweight.
The most effective strategy is to discuss how excessive weight increases the risk of diabetes, high cholesterol, or hypertension, among other health problems, said Church.
“You don’t want it to sound like a vanity issue — your weight is impacting your health,” he said. Not only can it raise your risk of certain diseases, but often for people in terms of mental health or sleeping well. “Let’s not think of it as one more thing to add to the list that’s wrong — this is likely the cause of those problems,” Church said.
The benefits of losing weight start when people drop only 3 percent of their body mass, according to the report, so emphasizing that a little effort can really help health outcomes can be encouraging.
Another benefit of doctors bringing up this issue is that if a primary care doctor recommends a patient to a nutritionist or other doctor, it’s more likely that the subsequent appointment will be covered by insurance, Drab said. Other changes to insurance under the Affordable Care Act emphasize preventative care, which is also expanding the number of services that will be covered.
Anyone who is heading into a general checkup should make feel comfortable , Drab said, and hopefully these new recommendations will ensure doctors know how to best support their patients.
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