Doctors Who Help in Obesity

Most people who are living with obesity or a history of obesity can tell some pretty appalling stories about doctors who have shamed and humiliated them. We know the studies and it’s all too common. But what about the growing numbers of doctors who help in obesity?

A new study from Johns Hopkins suggests that helpful primary care doctors can play an important role in reducing the health burden of obesity for their patients. Wendy Bennett and colleagues looked at the interactions between primary care providers (PCPs, mostly physicians) and patients in the POWER weight management study. They found that when PCPs were seen as helpfully involved in weight management, patients lost significantly more weight over a period of two years. The difference amounted to about six pounds.

What this finding points to is potential. Outside of a clinical trial, it’s reasonably well understood that primary care providers don’t get very involved in obesity care. Much of the front-line clinical care for obesity is delivered by many thousands of registered dietitians with training in weight management.

Despite considerable growth in the number of obesity medicine physicians, the numbers of these specialists are unlikely to meet the needs of people with obesity any time soon. And many of them are in fact from primary care specialties — family medicine, internal medicine, and gynecology.

Jamy Ard points out in a recent review in the BMJ:

The best opportunity for broad scale treatment of obesity may lie in the primary care setting. But questions remain about the optimal role of the primary care provider in the treatment of obesity and the prevention of weight gain, as well as potential systems approaches to the treatment of obesity.

It seems clear that primary care physicians, physician assistants, and nurse practitioners must gain skills to help meet the needs of people with excess weight and obesity.

The Bennett study shows that PCPs can make a difference if they join the conversation in a helpful way.

Click here to read the study, here to read more from WebMD, and here to read Ard’s review in the BMJ.

Doctor Archiméde Makaya, photograph © CIFOR / flickr

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August 26, 2015

2 Responses to “Doctors Who Help in Obesity”

  1. August 26, 2015 at 11:12 am, Ellen Glovsky said:

    It would be most helpful for the “burden of obesity” if you would write about the Health At Every Size approach as opposed to “weight management.” What if we focused on WELLNESS and health indicators, instead of the number on the scale. Maybe all overweight people don’t need to, or are not able to lose weight and keep it off. Consider the HARM we do by making them all feel they are doing something wrong when they don’t or can’t lose weight.

    • August 26, 2015 at 2:45 pm, Ted said:

      Ellen, thanks for taking the time to share your thoughtful comments. In answer to your suggestion that I write about the Health at Every Size approach, I must say that I don’t feel qualified. I believe deeply that everyone needs to find good health in their own body and that body size is biologically driven, not consciously chosen. I also know that people have trademarked the concept of Health at Every Size and that they have some very specific beliefs that they attach to that concept. I hear different things from different people about this concept and not everyone agrees which of those ideas lie at the core of the concept.

      I do, however, completely agree with you that we should focus on wellness and health indicators, instead of numbers on the scale. I agree that great harm can be done by telling people how much they should weigh and suggesting they are doing something wrong if they don’t.

      Again, thanks for your thoughtful comments and thanks for the work that you do.