Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Obesity Treatment in Primary Care

Evidence-based guideline aims to maximize outcomes

A new evidence-based guideline from the Society of Behavioral Medicine for obesity management and treatment in primary care is based on the 5A’s counseling framework (assess, advise, agree, assist, and arrange) and aims to address psychosocial issues, psychiatric and medical comorbidities associated with treatment failure. The guide recommends building a multidisciplinary team that helps patients lose weight and maintain their weight loss by:

• addressing patients’ psychosocial issues and medical and psychiatric comorbidities associated with obesity treatment failure

• delivering intensive counseling consisting of goal setting, self-monitoring, and problem solving

• connecting patients with community resources to assist them in making healthy lifestyle changes

Citation: Fitzpatrick SL, Wischenka D, Appelhans BM, et al. An evidence-based guide for obesity treatment in primary care. The American Journal of Medicine. [Published online ahead of print July 31, 2015]. doi: 10.1016/j.amjmed.2015.07.015.

Commentary: Combating obesity is the critical health issue of the next decade. Currently, two-thirds of the adult population is either overweight or obese, and if the current trend continues, diabetes, one of the most important consequences of obesity, will develop in one out of three Americans born today. Clinicians are generally good at accomplishing the first and second of the three “A’s” – assessing and advising1. The challenge for most of us in busy office practices is in assisting patients with the development of specific concrete goals using specific concrete behaviors, and then when appropriate, arranging for referral to nutritionists, personal trainers and multi-component programs to help patients accomplish the agreed upon goals. —Neil Skolnik, MD

1. Spring B, Ockene JK, Gidding SS, et al. Better Population Health Through Behavior Change in Adults. Circulation. 2013;128:2169-2176.