September 2019 #obsm chat blog: Obesity Management & Primary Care
Written and hosted by Dr. Sylvia Gonsahn-Bollie, M.D.**
Primary care is considered the gateway into the US healthcare system. With two thirds of Americans being designated as having overweight or obesity, it’s likely that most seeking help with their weight will initially see their primary care doctor or provider. Furthermore, in the US, the Physician Quality Reporting System has included body mass index (BMI) screening and follow-up as a quality measure monitored through the Centers of Medicare and Medicaid. Sadly, the data suggests that not many primary care physicians and providers are adequately equipped to address patients’ weight issues. The barriers faced to delivering adequate obesity counseling and care include: lack of clinical training, time constraints, doubts regarding the efficacy of weight counseling, shortage of resources and space clinically, and difficulty with insurance reimbursement.
As a primary care physician who is now also a board-certified obesity specialist, I have experienced these barriers first hand. Initially I was not fully aware of my shortcomings in clinical knowledge regarding obesity. Prior to studying for my American Board of Obesity Medicine exam I assumed I practiced “obesity medicine.” After all I diagnosed patients with obesity based on their BMI, offered quick interventional counseling usually to the tune of what I had been taught in medical school--“eat less, exercise more”-- and referred to a dietician when possible. However, it wasn’t until I had my own weight struggle that I realized the inadequacy of that advice. Also, it’s inaccurate.
My additional training in obesity medicine introduced me to the complexity of the disease of obesity. Obesity’s etiology is multifactorial and thus, in my clinical practice, I use a multimodal treatment approach to treating it. The Obesity Medical Association recommends taking into consideration the individual’s nutritional, behavioral, and fitness needs and, if needed, adding anti-obesity medication or bariatric procedures. I also go further and incorporate key lifestyle factors such as faith and family, working to help create personalized, evidence-based weight loss plans.
In this month’s #obsm chat we will discuss some of the difficulties in managing obesity in the primary care setting and generate potential solutions to empower both healthcare professionals and patients. Our questions for discussion will be:
What has your experience with weight management in primary care been as either a healthcare professional or a patient?
As a primary care professional, what types of treatment for obesity do you offer your patients? As a patient, what types of primary-care intervention have helped you manage your weight?
Have you ever faced weight bias in the primary care setting? If so how did you address it?
What are the strengths and challenges of managing obesity in the primary care setting?
How can we improve obesity management in primary care?
If you could tell a primary care professional one thing about caring for someone with obesity, what would you say?
We look forward to hearing your insights on this pertinent topic!
**Dr. Sylvia Gonsahn-Bollie is a busy wife, mom of two and physician specializing in Internal Medicine and Obesity Medicine in Silver Spring, MD. She is passionate about helping people obtain their happy healthy weight through practical evidence-based lifestyle interventions. Having lost 40lbs twice and sustained her weight loss > 5 years, she is committed to living what she teaches and inspiring others to do the same through “fitness inspired by teamwork”. You can visit her website www.drsylviagbollie.com and follow her on Twitter, IG and FB @FITTMD.