Primary care physicians and doctors in training should be equipped with a veritable bag of tricks they have handy to treat obese patients, experts suggested.
Healthcare professionals should have “a rigorous background in the biologic and pathophysiological foundations of obesity,” a core understanding of nutrition, and the ability to sufficiently motivate and follow up with patients in maintaining treatment, according to James Colbert, MD, of Brigham and Women’s Hospital, and Sushrut Jangi, MD, of Beth Israel Deaconess Medical Center, both in Boston.
“The front lines of the obesity epidemic often lie in a primary care doctor’s office,” despite how overworked and “focused on pharmacologically treatable conditions” primary care doctors are, they wrote in a perspective piece in the Oct. 10 issue of the New England Journal of Medicine.
In addition, Colbert and Jangi suggested that healthcare professionals learn to function as part of an interdisciplinary care team consisting of physicians, nurses, medical assistants, social workers, nutritionists, and behavioralists, adding that learning to function in such a coordinated effort is a necessity to “replace the antiquated model of the solo physician and patient.”
The recommendations are “far too ambitious,” commented David Katz, MD, MPH, of the Yale University Prevention Research Center in Derby, Conn.
“Obesity is not really a clinical problem — it’s a cultural problem,” Katz told MedPage Today, adding that the “remedy” for it is also cultural. “Doctors need to be trained to facilitate the solution, but the notion that doctors will bring the obesity epidemic under control is symptomatic of our tendency to over-medicalize everything,” he said.
Katz did note that “relatively little constructive intervention” occurs in the primary care field and that doctors could play a bigger role in getting patients to adhere to a lifestyle not conducive to growing waistlines.
The authors noted that — like interventions for obesity — education in treatment for the condition should begin while both patients and practitioners “are young and lifestyles and behaviors are easier to change.”
The need for change and education were echoed by Keith Ayoob, EdD, RD, of Albert Einstein College of Medicine in Bronx, N.Y.