With the advent of powerful obesity medications that address the biological basis of obesity, the field of obesity care is rapidly shifting.
To reflect this, the first Standards of Care on pharmacologic treatment of obesity published by the American Diabetes Association (ADA) were just released.
I had the honor of serving on the ADA Professional Practice Committee for Obesity that was responsible for writing them.
As I educate healthcare professional across the country, I continue to hear the following:
- “I’m waiting for my patient to take diet and exercise changes more seriously before I prescribe an obesity medication.”
- “When patients can demonstrate better commitment to making lifestyle modification and losing a few pounds, that shows me they’re ready for a medication.”
New research is challenging these traditional beliefs in obesity care, some of which may be rooted in obesity bias.
Change can also be hard for clinicians who are hesitant to prescribe a medication that has potential side effects, is expensive and may need to be taken lifelong.
In an effort to improve patient health outcomes, here are 3 ways the new recommendations guide clinical obesity care:
1-A Person-Centered Care Approach Leads the Way
The first recommendation of the Standards of Care emphasizes that selecting obesity medications should be person-centered using shared decision making.
This incorporates the patient’s personal values, goals, and health status.
Nutrition, physical activity, and behavioral therapy should be used in combination with obesity medications to achieve health goals.
These recommendations are consistent with a holistic care approach to the treatment of obesity.
2-Consider Obesity Treatment Like Other Chronic Diseases
It may be helpful to think about treating a patient with the disease of obesity similar to treating someone with another chronic illness.
For example, when a patient presents with uncontrolled diabetes or hypertension, our goal is to reduce the risk, commonly by prescribing a combination of lifestyle counseling and medication.
Accordingly, the new Standards of Care recommend that OBESITY MEDICATIONS SHOULD BE OFFERED AS PART OF INITIAL TREATMENT of obesity when accompanied with or at high risk of obesity-related complications.
This proactive approach is intended to prompt more urgent treatment when a patient would benefit from multimodal treatment of obesity.
3-Biological Treatments Open the Door for Improved Self-Care
We have repeatedly seen that the use of highly effective obesity medications that reduce hunger and food noise and increase satiety allow patients to follow a calorie-controlled healthy dietary pattern with more resolve and control.
And the resulting weight loss allows patients to engage in more physical activity along with an improved quality of life.
The healthcare professional’s treatment decision is not a question of counseling on lifestyle modification OR prescribing an obesity medication – the QUESTION IS HOW CAN THESE TREATMENT MODALITIES WORK TOGETHER?
Healthcare professionals looking to become more skilled in providing effective and efficient patient-centered weight management care within their existing practices, can check out my new book, Patient-Centered Weight Management.
You can also read the full Standards of Care published article here.
These new Standards of Care should EMPOWER PATIENTS to also be proactive and bring up the topic of obesity medications with their clinician earlier in their care.
RK
Robert Kushner, MD
