Physician San Diego Sports medicine and Family Health Center Weight Management San Diego, California
Participants should be aware of the following financial/non-financial relationships: . Michelle Look, MD, FAAFP, ABOM: Disclosure information not submitted.
Early Intervention in Weight Management: Treating Pre-Obesity By Michelle L. Look, MD, FAAFP
As healthcare providers, we are accustomed to treating patients with obesity, existing comorbidities and those with a body mass index (BMI) ≥30. Helping high-risk patients navigate their health issues and offering clinical support is what we do every day. However, research shows that providers can positively impact patient outcomes by taking a more proactive approach before obesity. Recognize the Risk New research suggests that the risk of increased chronic disease and mortality actually starts with a lower BMI. Infact according to The Global BMI Mortality Collaboration Trial, the relationship of BMI and all cause mortality and cause specific mortality has a J shaped curve with the change point at a BMI of 25 or pre-obesity not at 30. This newly identified BMI benchmark is a call to action for providers to intervene earlier and educate patients especially as studies show a large number of patients with pre-obesity will transition to obesity. Screening for a BMI of 25 and above is the first step for primary care physicians to evaluate metabolic, psychologic and functional effects of their elevated weight on their patients. This ensures no patients fall through the cracks and empowers providers to offer clinical guidance and emotional support from the get-go. Manage Patients with Pre-Obesity Working with patients who struggle with pre-obesity and obesity is extremely complex due to the many facets of the disease. Obesity is affected by Family history, lifestyle confines, pre-existing conditions and psychological issues. Obesity may be challenging to treat, but with evidence-based strategies and chronic disease management, patients can achieve significant health improvements and avoid complications. With pre-obesity and obesity affecting more than 73% of U.S. adults, there’s never been a more critical time to address this widespread epidemic. Identifying patients with pre-obesity is the first step to helping patients with an unhealthy weight or elevated BMI. Patients should be alerted that an elevated BMI of 25 and above has significant health risks. When providers “medicalize” a diagnosis, patients may take their increased weight more seriously and be motivated to prevent the transition to obesity. Patients should be educated on the benefits of even 5-10% weight loss. A comprehensive treatment plan for their weight loss including lifestyle changes, behavior modification, and long term follow up with their physician increases success. Additionally, there are a variety of FDA-approved medications and devices that have proven to be effective to combat pre-obesity. As more research is done on the population with pre-obesity and a BMI of 25, providers will gain additional insights that will undoubtedly assist even more patients. In the meantime, we will continue to educate providers and patients about the increased risk of a BMI of 25 and share findings with the primary care medical community.
Learning Objectives:
Recognize the risk of disease burden associated with pre-obesity
Understand the importance of proper screening techniques for weight history
Become familiar with evidence based practical treatment strategies for patients with pre-obesity