|Integrating Effective Weight Management Strategies into Clinical Practice|
Despite the known effectiveness of lifestyle modifications for weight loss and weight management, only 20 percent of overweight and obese patients are being screened, diagnosed, and treated according to established medical guidelines. Until healthcare providers commit to clinical weight management, millions of patients will continue to unnecessarily struggle with their weight and suffer significantly higher rates of chronic disease and mortality.
The American College of Preventive Medicine (ACPM) encourages healthcare systems and primary care providers to incorporate weight management strategies into clinical practice and increase patient referrals to effective, evidence-based weight management programs in their community.
“We need to accept the transforming clinical models of practice at the individual and public health levels that incorporate evidence-based lifestyle interventions to meet the needs of weight management, especially among underserved populations,” said Ingrid Edshteyn, DO, MPH, ACPM member and lead author of the statement. “Preventive medicine physicians can play an especially vital role in implementing a systems-based approach to addressing obesity.”
Although the causes of obesity are complex, discussions about weight and the consistent administration and reimbursement of intensive, multicomponent behavioral interventions must become standard practice in the primary care setting. Physicians should work to better recognize obesity, and enhance their ability to counsel patients regarding weight reduction, nutrition, and physical activity. Physician education—such as the new Lifestyle Medicine Core Competencies Program—can address these skill gaps doctors cite as major barriers to counseling patients.
Effective weight management interventions utilize a lifestyle approach, one that integrates physical activity, nutrition, behavioral management, and gives attention to psychosocial needs. According to the American Heart Association, the most effective programs are in person, high intensity (more than 14 sessions in six months), and led by a trained interventionist who can successfully administer techniques such as self-monitoring, stimulus control, goal setting, behavioral contracting, reinforcement, and the normalization of healthy eating.
Quality weight loss interventions—including commercial and community programs that satisfy ACPM’s Weight Management Certification requirements—should be encouraged as a primary approach to helping patients achieve a clinically significant 5 to 10 percent reduction in weight.
Few clinical programs meet all quality standards, making it important for providers to increase patient access to rigorous, evidence-based interventions that are available in-person, online, or a combination of both. Strengthening clinical–community connections may also provide opportunities to address obesity-related risk factors and implement multifaceted, holistic interventions at community levels.
A commitment by providers to embrace lifestyle interventions as part of clinical weight management has the potential to significantly reduce associated morbidity from diabetes and cardiovascular disease, improve emotional health and quality of life, and decrease healthcare costs.
Conclusions published in the full report (Am J Prev Med, 2016;51(4):542–548) were developed in a consensus-based manner by the ACPM Prevention Practice Committee following a review of the current scientific literature and are endorsed by the ACPM Board of Regents. ACPM is a professional medical society specializing in disease prevention and population health. The views expressed are the authors and do not reflect the views of the authors’ federal or state agencies or private institutions.
Ingrid Edshteyn, DO, MPH
Paul Bonta, MA
Practice Policy Statement: Integrating Effective Weight Management Into Practice. Ingrid Edshteyn, DO, MPH; Kelechi A. Uduhiri, MD, MPH, MS; Toyosi O. Morgan, MD, MPH, MBA; Katrina L. Rhodes, MD, MS; Kevin M. Sherin, MD, MPH, MBA; and the American College of Preventive Medicine Prevention Practice Committee. Am J Prev Med 2016. Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine. Link.