Treatment of Obesity in Primary Care Practice in the United States: A Systematic Review

Tsai, Adam Gilden; Wadden, Thomas A.

doi:10.1007/s11606-009-1042-5

Cited by 197 publications

(199 citation statements)

References 69 publications

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“…Our finding that few individuals with obesity make it to the end of the cascade suggests that there is significant unmet need for obesity care at the population level. Engaging with this last step is essential to gaining access to managed, effective care and can result in a myriad of treatment outcomes, including behavioral modification, pharmacotherapy, bariatric surgery, and/or referral to another care provider 17, 18, 19, 20, 21. Our findings thus highlight the need for physicians to engage in conversation about obesity treatment at routine clinical visits, even when patients are not seeking obesity care.…”

Section: Discussionmentioning

confidence: 82%

Prevalence and Determinants of Engagement with Obesity Care in the United States

Stokes

Collins

Grant³

et al. 2018

Obesity

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ObjectiveMedical management of obesity can result in significant weight loss and reduce the burden of obesity‐related complications. This report employs a new conceptual model to quantify engagement with obesity care and associated determinants in the US adult population.MethodsEngagement with obesity care was conceptualized as a cascade comprising 5 successive steps: perceiving oneself as overweight, desiring to lose weight, attempting weight loss, seeking care from a health care professional for obesity, and seeking care from a physician specifically.ResultsAmong adults with obesity, 7.3% did not perceive themselves as overweight, 1.5% perceived themselves as overweight but had no desire to lose weight, 29.9% wanted to lose weight but did not try in the last year, 51.3% tried to lose weight but did not consult a health professional, and 6.4% sought help for weight loss from a health professional but not a physician, implying that 96.4% of the population with obesity had an unmet need for obesity care.ConclusionsThis analysis provides new insight into the most common points along the cascade at which disengagement occurs and can inform efforts to improve uptake of obesity‐related health care services.

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Section: Discussionmentioning

confidence: 82%

Prevalence and Determinants of Engagement with Obesity Care in the United States

Stokes

Collins

Grant³

et al. 2018

Obesity

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“…2,4,5 Physician acknowledgement of patients' overweight status and advice to lose weight increase the accuracy of patient weight perceptions, attempts to lose weight, and weight loss. [6][7][8] However, advice is delivered in only 13% of visits with overweight patients. 9,10 Physicians also rarely provide guidance on how to achieve weight loss.…”

Section: Introductionmentioning

confidence: 99%

Electronic Tools to Assist with Identification and Counseling for Overweight Patients: a Randomized Controlled Trial

et al. 2012

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“…These new treatment options have enabled the development of more robust approaches to medical care that not only optimize the benefit–risk balance and improve outcomes but also are cost‐effective 1, 12, 13, 14, 15.…”

Section: New Tools and The Role Of Primary Care Providersmentioning

confidence: 99%

“…The long‐term follow‐up will give the PCP an opportunity to address small weight gains by reinstituting the lifestyle intervention and to assess the need for weight‐loss medications or bariatric surgery 12. Several models have been developed to help PCPs manage obesity and provide behaviour support to promote sustained weight loss (Box 4) 1, 14, 15.…”

Section: Medical Models and Guidelinesmentioning

confidence: 99%

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Weight maintenance: challenges, tools and strategies for primary care physicians

2015

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SummaryObesity is recognized as a chronic disease and one of the major healthcare challenges facing us today. Weight loss can be achieved via lifestyle, pharmacological and surgical interventions, but weight maintenance remains a lifetime challenge for individuals with obesity. Guidelines for the management of obesity have highlighted the role of primary care providers (PCPs). This review examines the long‐term outcomes of clinical trials to identify effective weight maintenance strategies that can be utilized by PCPs. Because of the broad nature of the topic, a structured PubMed search was conducted to identify relevant research articles, peer‐reviewed reviews, guidelines and articles published by regulatory bodies. Trials have demonstrated the benefit of sustained weight loss in managing obesity and its comorbidities. Maintaining 5–10% weight loss for ≥1 year is known to ameliorate many comorbidities. Weight maintenance with lifestyle modification – although challenging – is possible but requires long‐term support to reinforce diet, physical activity and behavioural changes. The addition of pharmacotherapy to lifestyle interventions promotes greater and more sustained weight loss. Clinical evidence and recently approved pharmacotherapy has given PCPs improved strategies to support their patients with maintenance of weight loss. Further studies are needed to assess the translation of these strategies into clinical practice.

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Treatment of Obesity in Primary Care Practice in the United States: A Systematic Review

Cited by 197 publications

References 69 publications

Prevalence and Determinants of Engagement with Obesity Care in the United States

Prevalence and Determinants of Engagement with Obesity Care in the United States

Electronic Tools to Assist with Identification and Counseling for Overweight Patients: a Randomized Controlled Trial

Weight maintenance: challenges, tools and strategies for primary care physicians

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