AAPA: Stemming the rise in obesity through effective care delivery

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Obesity is recognized as a chronic progressive disease resulting from multiple environmental and genetic factors.
Obesity is recognized as a chronic progressive disease resulting from multiple environmental and genetic factors.

“More die in the US of too much food rather than too little.” —  Galbraith (1958)

As healthcare professionals, we understand that obesity is a major health issue — one that often leads to more complex medical conditions such as heart disease, diabetes, high blood pressure, and more. Beyond the clinical impact, many of us may also be personally affected by the issue. Regardless, the statistics illustrate that the obesity rate continues to increase. Surgeon General Jerome Adams recently cited obesity as one of the top 3 priorities for the US Department of Health and Human Services — alongside the opioid epidemic and mental health. Physician assistants (PAs) are well positioned to become leaders in solving this problem.

By the numbers

Earlier this month, the Centers for Disease Control and Prevention (CDC) released new research finding that nearly 40% of adults and 19% of youth are affected by obesity. The adult rate is the highest ever in the United States. Estimated national costs for conditions stemming from obesity range from $147 billion to nearly $210 billion, and patients diagnosed with obesity contribute to 42% more in healthcare spending than those who are not affected by obesity. These numbers are staggering, but nothing can adequately measure the emotional and physical toll that obesity can have on a patient.

Managing obesity effectively

Given the complexity and financial implications of the disease, proactive care coordination is necessary to have a significant impact. Population health management (PHM), a discipline that facilitates care delivery across a general population and strives to gather and analyze clinical data across a patient's many care settings, can also reveal opportunities to improve patient health. Some of the benefits of PHM — which requires data analytics technology to be effective — include identifying actionable steps on how to treat a certain population, reduce costs, and assist in the transition to value-based care.

In addition to prioritizing care coordination and PHM, there are 3 steps that I believe all healthcare professionals can take to become part of the solution.

  • Gain baseline knowledge in diagnosis and treatment: Obesity is recognized as a chronic progressive disease resulting from multiple environmental and genetic factors. Understanding some of the basics of the science and pathophysiology behind the disease may help providers have more effective, positive conversation with patients and overcome potential obesity biases and improve empathy toward patients who struggle with obesity. Understanding the pathophysiology of obesity will also help develop more effective treatment and prevention plans.
  • Talk about it more: An NIH study found that rates of weight-related counseling in primary care have significantly declined despite increased rates of obesity. Another study from BMC Health Services indicated that patients have greater success in weight loss when they receive guidance, education, and encouragement from their healthcare provider. Recognizing and talking about obesity as a chronic, relapsing disease is one of the needed starting points to help improve the obesity epidemic and patients' overall health and quality of life.
  • Be consistent: Obesity is a chronic condition that requires ongoing monitoring and care and medical management. Providers who deliver comprehensive care along with frequent ongoing monitoring can go beyond treating symptoms and help patients live healthier lifestyles by improving body mass index and reducing the risk of developing other chronic illnesses. Comprehensive care should include behavioral counseling, nutritional guidance, physical activity recommendations, and when clinically appropriate pharmacotherapy, or referral to an obesity medicine specialist or bariatric surgeon.

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