Since obesity is such a wide-spread and significant health problem, people may think that most primary care physicians are discussing the dangers of obesity and treatment options with all their overweight/obese patients. However, this does not appear to be the case. Now groups including the American Heart Association (AHA) are hoping to change that. This group of prominent medical organizations that includes the AHA, the American College of Cardiology and The Obesity Society, has published new guidelines for fighting the nation’s obesity epidemic. They urge primary care providers to be a lot more aggressive about helping patients lose weight. The guidelines highlight that providers should calculate patients’ body mass index (BMI), a weight-to-height ratio. If a patient needs to lose weight, they should come up with a plan which may include counseling, dietary therapy, or weight loss surgery procedures such as the Lap-Band, gastric bypass or gastric sleeve. In taking these actions, this will likely be a substantial change for many physicians who do not address weight and weight loss in depth, or at all.
The fact is that the majority of Americans need to lose weight. The Centers for Disease Control and Prevention (CDC) estimate that more than 35 percent of adults in United States are obese, defined as BMI of 30 or greater. Excess weight can trigger type 2 diabetes and lead to heart disease and other health problems. However, surveys have shown that only about one third of obese patients recall their physician talking to them about their BMI or counseling them about weight loss. These new guidelines strive to change this, and give providers the tools they need to address the prevalence of obesity they see in their patients.
The guidelines advise providers to:
- Calculate patients’ BMI, measure their waists and tell them if they are overweight or obese at least once a year.
- Develop a weight loss plan that includes moderate calorie-cutting and exercise.
- Refer overweight and obese patients who are headed for heart problems to weight loss programs. Specifically, discuss enrolling them in at least 14 face-to-face counseling sessions over six months with a registered dietitian, psychologist or other professional with training in weight management.
- Recommend weight loss surgery for patients with a BMI of 40 or for those with a BMI of 35 who also have other risk factors, such as diabetes or high blood pressure.
In 2013, the American Medical Association, the nation’s largest group of physicians, labeled obesity a disease, a measure intended to get doctors to pay more attention to the problem and prod more insurers to pay for treatments. By next year, most insurance companies are expected to cover counseling and other obesity treatments, following in the steps of the Medicare program, which began paying for one-on-one help last year.
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