We are at a crossroads where the advancements in obesity science and treatment outpace a workforce that is not fully prepared to apply these breakthroughs.
This is the first line in the Introduction to my just-released book published by the Academy of Nutrition and Dietetics, called Patient-Centered Weight Management: The Six Factor Professional Program and Toolkit.
I have always been passionate about educating clinicians with varied backgrounds on providing patient-centered weight management care.
I wrote this book because the field of obesity care is shifting and many clinicians are struggling to keep up.
While we all are enamored with the new obesity medications, I believe that there are 3 essentials of overweight and obesity care not to be overlooked.
I highlight them here:
1-Targeted Lifestyle Modification Counseling is Still Foundational
Although there are breakthrough obesity medications that address the biological causes of obesity, healthcare professionals are left uncertain regarding the role and necessity of delivering adjunctive lifestyle modification counseling.
And yet, the research is clear that when patients modify their diet, physical activity, sleep habits and stress coping behaviors, their health and quality of life improve.
And for patients taking the new obesity medications, counseling strategies need to ensure that patients are consuming a high-quality diet and engaging in both aerobic and resistance exercise.
But how can targeted lifestyle modification counseling be provided that is both effective and efficient?
2-Focus on Improved Health Outcomes and Quality of Life, Not Just Weight Loss
Though we are a society obsessed with body weight, a narrow focus on weight loss is not the ultimate goal.
Instead, improved weight management outcomes that include better health and quality of life is the focus.
For patients, this may mean improvement in obesity-related complications, such as diabetes, high blood pressure, sleep apnea or arthritis.
It may also translate into better physical functioning with less pain or shortness of breath.
For others, it translates into improved social connections and mental health.
3-Address Weight Bias and Stigma Upfront
Self-imposed judgement, doubt and feelings of failure are common among individuals living with obesity.
Weight bias and stigmatization can arise from a lifetime of interactions with family members, healthcare providers, teachers, employers, colleagues, well-meaning friends and the media.
Even when patients take action to control their weight with one of the new obesity medications, they can be shamed for taking the “easy way out”.
And yet, patients being treated for other chronic diseases like diabetes, hypertension or cancer are never shamed for taking approved medication treatments.
Self-blame often prevents individuals from seeking evidence-based obesity care or working openly with clinicians.
That’s why up front, clinicians need to tell patients that obesity is a disease and is not their fault.
Addressing this misbelief and setting realistic expectations head-on is an important first step in the obesity care process.
RK
Robert Kushner, MD
