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Obesity in Primary Care: Treatment

Obesity in Primary Care: Treatment

There is general agreement that, to lose weight and keep the weight off long-term, an improvement on lifestyle factors is a key component. Healthy eating, active lifestyle, good sleeping habits, and optimal strategies to deal with stress and anxiety all are important components of a weight loss program. Keep in mind that because weight loss usually is associated with increased hunger, the use of medications to reduce appetite might be very helpful.

Key Treatment Questions

Following are answers to the questions primary care physicians most often ask about obesity treatment:

• How do I treat a patient with obesity?

As with any other chronic disease, obtaining a detailed medical history is very important. With this information, you can design a specific lifestyle intervention program personalized for each patient. In addition to information regarding the obesity risks and weight loss options, 5 specific areas should receive special attention: nutrition, physical activity, appetite control, quality of sleep, and psycho-emotional stage. Following are some recommendations for nutrition and physical activity.

Nutrition: Obese patients need to improve the quality of their diet. They usually need to reduce calories, but it’s important that they don’t become hungrier. In many physical senses, patients may benefit from a visit with a dietitian.

Reducing the calories the patient is taking in by 30% is a good technique, but it’s not always easy to know how many calories the patient is actually consuming. Maintaining the calorie amount at about 1200 to 1800 daily and just reducing the proportion of fat and carbs is an alternative. To be successful in this area, provide specific information to patients so they can make good choices when shopping, cooking, and eating every day.

Keep in mind the patient’s cultural background, traditions, food availability, time constraints, financial issues, nutritional knowledge, and cooking skills. Follow-up with a knowledgeable team of dietitians will be based on supervising the quantity and quality of meals and the patient’s adherence to a healthy nutritional plan.

According to strong data in the literature, a Mediterranean diet—including poultry, fish, vegetables and fruits, whole grains and beans, olive oil, nuts, and seeds—seems to be the healthiest to follow.

Next: What About Physical Activity?

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