New Year’s resolutions are popular for patients who want to take control of their health, but what about resolutions for physicians? Here are 3 goals for 2023 that offer powerful ways to support patients on their weight management journey and enhance your practice as well.
Obesity is not simply a number – whether that’s on a scale or a body mass index (BMI) measurement. It’s an interconnected, complex condition that requires a multifaceted treatment approach. Individuals with obesity are often navigating behavioral and physical challenges, so it’s critical to address all potential factors that contribute to weight management roadblocks.
While BMI is still considered a standard screening tool for obesity, keep in mind it’s just one piece of the puzzle. Body fat percentage, ethnicity, overall health, and physical function are other factors that should be considered when evaluating a patient for obesity. Some patients with “normal” BMIs may benefit from weight loss if they have diabetes or cardiovascular disease, while some persons with higher BMIs may be physically fit and have a healthy body fat distribution. Measuring body fat percentage or waist-to-hip ratios can provide additional context to BMIs.
Just as the cause of obesity is multi-layered, treatment can be as well. Clinicians can leverage nutrition, physical activity, antiobesity medications, bariatric and metabolic surgery, and behavior counseling to address all possible root causes of obesity.
Every discussion is an opportunity to either strengthen the physician/patient relationship or demotivate and disengage the patient. Language plays a major role in motivation and connection, so avoiding terms like “fat” and “obese” goes a long way in securing the patient’s buy-in.
It’s not easy to have conversations about a patient’s weight but engaging them and listening to their perspective first can lead to a more productive, collaborative relationship. Great conversation starters include:
Another effective adjustment is moving to person-first language, such as “individual with obesity” rather than “obese person.” By acknowledging the individual first, clinicians can lessen the impact of weight bias and stigma. A study found that 50% of patients with overweight or obesity reported feeling stigmatized on multiple occasions by physicians. Additionally, 70% of women said physicians were a source of weight-related stigma. Changing the narrative in a clinical setting can have far-reaching, positive effects outside the office walls.
Prescribing medication is a powerful way to build weight loss momentum. These agents increase the rate of success beyond diet and exercise alone, and the US Food and Drug Administration continues to approve new therapeutic options. One study found that patients who take prescription weight loss medication while also making lifestyle changes lose 3% to 12% more of their starting body weight than persons who make lifestyle adjustments without medication. It’s important to note, however, that drugs that promote weight loss are not a short-term fix; it requires long-term use.
As of early 2023, the newest antiobesity medication is Wegovy®. This medication is one of the most effective options available, associatedwith an average weight loss of around 15%. It is a weekly injection and can be expensive without insurance coverage.
There are other exciting medications and treatment options available, including the daily injection Saxenda® and oral agents Qsymia®, Contrave®, and phentermine. The device Plenity® is also a new prescription option for patients with lower BMIs (typically ≥25 kg/m2). The entire toolbox of treatment options should be considered when deciding how to treat patients, while keeping in mind side effects, interactions, medical history, and cost.
For in-depth resources on obesity management, access to industry experts, and opportunities to expand your clinical network, join the Obesity Medicine Association (OMA).
OMA is hosting the Obesity Medicine 2023 Summit from April 21-23. Sessions will focus on the integration of skills in obesity medicine with an emphasis on practical treatment strategies, treating patients in special populations, patient engagement, practice and business management, research, and diving deep into a variety of patient case studies. Learn more and register here.