From an ACOFP educational partner
Obesity is a chronic, progressive, and relapsing disease associated with significant morbidity and mortality. In the United States, an estimated 42% of adults have obesity--a number that is predicted to reach almost 50% by 2030.
At the patient level, obesity is associated with increased risks for a wide variety of comorbidities including cardiovascular disease, metabolic syndrome, type 2 diabetes, nonalcoholic fatty liver disease, dyslipidemia, hypertension, cancer, and kidney disease. Excess weight is associated with a nearly 3-year reduction in life expectancy and nearly 500,000 deaths per year in the United States alone. On the other hand, weight reduction is associated with decreased complications and improved outcomes for patients with obesity. Ideally, this chronic disease would be prioritized for medical management based on the significant risks it poses to patient health. However, obesity has long been stigmatized as a personal issue and has only recently become accepted as a chronic disease that requires clinical intervention.
Improving the quality of care for people with obesity and overweight is multifaceted, requiring addressing deficiencies in both diagnosis and management. For one, obesity is underdiagnosed because it is not viewed as a treatment target. However, with increasing recognition that obesity is affected by underlying genetic and adaptive physiological processes, and that lifestyle modifications fail to produce sustained weight loss for most patients, management of obesity has shifted from just a reduction in body weight to the broader goal of improving health and quality of life through reduction of obesity-related complications.
A revolution in management has also occurred, with improved treatment options. Until recently, the few medications available to treat obesity were relatively ineffective; however, GLP-1 and dual GIP/GLP-1 receptor agonists have demonstrated meaningful weight loss with corresponding improvements in cardiometabolic parameters. Yet, healthcare providers only rarely incorporate medications for weight management in treatment plans, indicating a failure to adhere to guidelines that recommend the use of pharmacotherapy for patients who have not met weight loss goals (≥5% of total body weight at 3-6 months) with lifestyle intervention alone. Knowledge of the different agents and their efficacy and safety profiles, administration characteristics, and mechanisms of action, will allow clinicians to provide appropriate patient-centered care incorporating pharmacologic therapies along with the lifestyle and behavioral interventions that are the cornerstones of weight management.
The tenets of osteopathic medicine make osteopathic family physicians an effective bridge to developing personalized obesity care for patients. Effective obesity management requires comprehensive management practices that include counseling patients about the importance of lifestyle modifications as a complement to pharmacotherapy. To support these efforts, UChicago Medicine, in collaboration with the Academy for Continued Healthcare Learning, has developed a training program modeled on the CDC Training of Trainers framework.
Clinicians can use the training to address their own educational needs or support team-based education at their practice. Upon completing the training, clinicians may also opt to participate in a noncommercial speaker bureau, making themselves available to their colleagues across the country who seek peer-to-peer education.
