Obesity care is a team sport.
One clinician does not have to shoulder all the responsibility nor is expected to have the necessary expertise in all aspects of care.
And yet, in some circles, you may think that team-based obesity care is a thing of the past as individuals get prescriptions for obesity medications with limited follow-up, education or referral.
But can one prescription for an injection or pill be enough to treat those with the complex, chronic, relapsing disease of obesity?
Multimodal therapy that may include lifestyle modification, medications and surgery has been and still is the gold standard of all chronic disease treatment like heart disease, diabetes or cancer.
With the advent of the highly effective obesity medications, we are seeing greater interest in obesity care than ever before from clinicians with varied backgrounds and the patients they treat.
Here are a few ways I have been reimagining interdisciplinary team-based obesity care as patients and professionals alike navigate this exciting new era:
1-More Clinicians with Varied Backgrounds Can Initiate and Lead Obesity Care
A patient’s primary care professional, whether it is a physician, physician associate or nurse practitioner, is always a good choice to initiate and lead care because they have a holistic approach to patient care.
However, the disease of obesity touches all medical specialties, ranging from Cardiology, Endocrinology, Ob/Gynecology to Gastroenterology, Orthopedics, Oncology and mental health professionals.
As clinician specialists gain confidence using new obesity medications and build the office infrastructure necessary to guide treatment, they are more likely to initiate care.
Alternatively, registered dietitian nutritionists, health psychologists or exercise specialists may initiate care and refer to a prescriber if they think the patient may be a candidate for one of the newer obesity medications.
The role of telehealth companies as team leaders is evolving and holds promise as long as interdisciplinary team-based care and referrals are considered when needed.
2- Medication Adherence and Improving Health Outcomes Guide Team-Based Care
The needs of patients treated with obesity medications vary widely.
Once identified, these needs can be matched with referral to the appropriate team member.
Although all patients must be provided with instructions on how to take medications and reduce GI side effects, some patients with nausea, constipation, or food intolerances may benefit from a registered dietitian nutritionist to improve diet quality and better manage GI side effects.
Individuals needing help with resistance training to preserve muscle mass and function may benefit from an exercise specialist.
A health psychologist may be in order for those patients seeking help with behavioral changes, mood disorders or stress management that may be interfering with their program.
Patients with complex medical histories can be referred to an obesity medicine specialist.
We are at a crossroads where we need more clinicians skilled in providing obesity care.
Using a team-based approach can be helpful.
Clinicians looking for more direction to improve health outcomes while providing obesity care in the midst of a busy practice, can check out my latest book for healthcare professionals, Patient-Centered Weight Management.
Patients wanting a program to better manage weight, while accessing the team members to help them be successful, can check out my book, Six Factors to Fit: Weight Loss that Works for You!
RK
Robert Kushner, MD
