Weight Can’t Wait: A Guide to Discussing Obesity and Organizing Treatment in the Primary Care Setting

Abstract

ObjectiveThe objective of this study was to develop a simple and practical guide for discussing and managing obesity in primary care settings.MethodsThis study convened representatives from 12 primary care and obesity specialty organizations for a series of roundtable meetings to discuss the key components of obesity treatment in primary care. Attendees identified the need for a guide for primary care providers that outlined the key steps for discussing obesity with patients and managing their care while recognizing the significant time constraints on such provider/patient encounters.ResultsPrevailing themes from the roundtable sessions suggested that the key components of addressing obesity in primary care settings are obtaining patient permission, addressing weight bias, providing a diagnosis, and emphasizing shared decision‐making. A modified "6A" framework with the steps “Ask,” “Assess,” “Advise,” “Agree,” “Assist,” and “Arrange” was deemed appropriate to organize the process of weight management in primary care. An algorithm was developed to provide a script for the patient/provider encounter.ConclusionsThe expert panel developed a short, accessible, practical, and informative guide for obesity management by primary care clinicians. Efforts are under way to disseminate the guide to primary care providers through the 11 participating organizations that have endorsed it.

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Recognition of Obesity and Perceptions of Weight Loss Management in Patients With Chronic Kidney Disease: A Retrospective Cross-Sectional Study

“…One example is called the "6A Framework," which provides a word-by-word script to engage with the patient and develop a shared decision-making weight loss plan. 28 Opportunity can be addressed by creating aids to help providers access anthropometric data on the electronic medical record (BMI flag) and create a streamlined referral process to a weight management program. A quality improvement intervention by Wang'ondu et al 29 demonstrated that educating providers on how to access weight and BMI from the medical record quickly increased documentation of obesity from 46% to 79%.…”

“…One example is called the “6A Framework,” which provides a word-by-word script to engage with the patient and develop a shared decision-making weight loss plan. 28…”

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