Tender love...compassion...care

Obesity Care: Giving Up, Doubling Down, or Getting Real?

Primary care providers face a dilemma. More than a third of adults have obesity. Providers spend 75% of their time managing the chronic diseases that result – things like type 2 diabetes, heart disease, cancer, and arthritis. So what should they be doing about obesity? Does telling a patient to lose weight mean that a provider is delivering good obesity care?

In a thoughtful essay, primary care physician Elisabeth Poorman says no. She has stopped telling her patients to lose weight:

First, we need to stop pretending that what we are doing is working. Our brief counseling sends the wrong message that weight loss is simple and easy, even though we know it’s not. We have to be frank with patients and tell them the truth: If they are willing to make weight loss a central goal of their lives, they can lose about 5 percent of their body mass. They can even keep it off if they change their lifestyle dramatically, and forever. We need to focus more on exercise, which will help people be healthier, even if they remain overweight.

She has a good point. Simply telling a patient to lose weight accomplishes little. We guarantee that a person living with obesity has already thought of that one. Time is better spent on listening and providing practical guidance for better health. Physical activity should indeed be a core part of that.

But that should not be the end of it, particularly for a patient with severe obesity. A good primary care provider coordinates care with specialists and allied health professionals for cancer, diabetes, and heart disease. They need to do the same for obesity. For someone with severe obesity, more intensive obesity care can be very beneficial.

Primary care providers must learn to coordinate care with the growing specialty of obesity medicine, with dietitians, with fitness professionals, and with surgical specialists.

Getting real about obesity care means coming to terms with the futility of simply telling a patient to lose weight. It’s absurdly demeaning. Getting real means tapping into the rapidly developing tools available for good obesity care. It means providing encouragement and access to tools for better health and wellness.

Click here for Poorman’s essay.

Tender love…compassion…care, photograph © atinirdosh / flickr

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October 16, 2016