Primary Care Providers are Listening

Published in February 2014 Issue             

The cover story for this monthís issue of connect examines the emerging sub-specialty of obesity medicine, and how a dedicated group of physicians, mostly primary care providers, are beginning to join ranks to address a disease that has long been undertreated and largely misunderstood or ignored.

But the rise of obesity medicine is only part of the picture of how the medical community is embracing evidence-based solutions rather than antiquated thinking that treats obesity solely as a lifestyle issue rather than a disease.

Just last year, the A.M.A., the nationís largest physicians organization, declared obesity a disease. While this did not change the world in an instant, it was a watershed moment in that it was a clear sign that the national conversation around obesity is changing. The A.M.A. President said at the time, ďThe purpose of the policy is to advance obesity treatment and prevention. It issues a call for a paradigm shift in the way the medical community tackles this complicated issue.Ē We still have a ways to go before medical practice and policy catches up to the science, but we are getting there.

More evidence things are changing. The American Heart Association (AHA), American College of Cardiology (ACC) and The Obesity Society released new obesity guidelines during ObesityWeek 2013. The NIH-commissioned guidelines, which finally updated the original NIH guidelines from 1998, recommend that doctors diagnose and treat obesity at every clinic visit "the way they would any other chronic disease." The guidelines are geared toward primary care physicians and offer an algorithm for managing obesity, which begins by routinely obtaining a patientís BMI. The guidelines focus on identifying at-risk patients and prescribing appropriate interventions or referring for bariatric surgery. Yes, primary care is being encouraged by its own to refer for bariatric surgery, something that used to be said in a whisper, is now being said out loud. Letís make that voice even louder.

Itís important for each one of us to promote these guidelines within our own communities and have a larger conversation about obesity and its treatment. Engage with your colleagues from primary care, cardiology, internal medicine, endocrinology, and other physicians and health professionals, including certified obesity medicine physicians. Talk about the disease of obesity, metabolic and bariatric surgery and the role and responsibility each one of us has in the spectrum of the disease. Itís not enough to let guidelines, declarations and evidence speak for itself. We must foster dialog and greater action on obesity. The opportunity is greater now than it has ever been before. Our patients are counting on us.