Treating Obesity In Primary Care

The latest information from the CDC demonstrates that 70% of Americans can be classified as having pre-obesity or obesity. This chronic disease is considered the cause of many other chronic diseases such as hypertension, dyslipidemia, diabetes, and nonalcoholic fatty liver disease, to name but a few of the 236 obesity associated disorders. Additionally, obesity is considered to be the cause of fourteen different types of cancers. Based on the number of people affected and the consequences of the disease, it is imperative that it is studied and treated by primary care providers. Few training programs for physicians, NPs or PAs are covering the basics of treating obesity. These fundamentals include pathophysiology, assessment of the disease, and the foundational components of treatment with eating plans, physical activity and behavioral interventions, then the supporting components of anti-obesity medications, devices and surgery. As a result, few of those currently in primary care practice have received any education in the evidence-based treatment of obesity. This book provides the reader with the education to understand the disease, the patient’s experience, and full evidence-based treatment. It also provides the opportunity to understand how to incorporate the treatment into primary care. Written by a leading expert in the field, Treating Obesity in Primary Care offers all clinicians providing primary care services the information needed to effectively treat the chronic disease of obesity.

The acknowledgment that obesity is a disease—a disease with enormous impact on both the public health and the economy and an incredible burden to its victims—has ?nally come. This ?nal recognition will hopefully free research dollars and will encourage third party payers to understand the need to cover services for treatment. Dr McKnight is an honored family medicine educator who combines his sense of academic rigor with the understanding of a compassionate family p- sician. Thus he approaches this clinical syndrome in the manner of a family physician: he aims to have an effect on the entire person and that person’s life, not just some disease entity. His broad-based approach draws on behavioral strategies, diet and exercise modi?cation, and limited use of pharmaceuticals in selected cases. The practical tools presented here will prove to be valuable ad- tions to the armamentarium of care teams that look to develop treatment plans for their patients with this disease. I myself have been obese as long as I can remember. I am the son of obese parents and my sister has shared this chronic problem. Over my lifetime I have dealt with almost all of the problems of obesity, and I have used all of the excuses. I have dealt with many obese patients during my years in practice, some who have said openly that they chose me as their physician because I really couldn’t tell them to lose weight, since I could not myself.

It is becoming increasingly important to examine the relationship between the outcomes of a clinical trial and the costs of the medical therapy under study. The results of such analysis can affect reimbursement decisions for new medical technologies, drugs, devices or diagnostics. It can aid companies seeking to make claims about the cost-effectiveness of their product, as well as allowing early consideration of the economic value of therapies which may be important to improving initial adoption decisions. It is also vital for addressing the requirements of regulatory bodies. Economic Evaluation in Clinical Trials provides practical advice on how to conduct cost-effectiveness analyses in controlled trials of medical therapies. This new edition has been extensively rewritten and revised; topics discussed range from design issues such as the types of services that should be measured and price weights, to assessment of quality-adjusted life years. Illustrative materials, case histories and worked examples are included to encourage the reader to apply the methods discussed. These exercises are supported with datasets, programmes and solutions made available online.

The Roundtable on Obesity Solutions of the National Academies of Sciences, Engineering, and Medicine held a workshop in Washington, DC, on April 6, 2017, titled The Challenge of Treating Obesity and Overweight: A Workshop. The discussions covered treatments for obesity, overweight, and severe obesity in adults and children; emerging treatment opportunities; the development of a workforce for obesity treatments; payment and policy considerations; and promising paths to move forward. This publication summarizes the presentations and discussions from the workshop.

This issue of Medical Clinics, Guest Edited by Drs. Scott Kahan and Robert Kushner, is devoted to Obesity. Articles in this outstanding issue include: Obesity as a Disease; Treating Obesity in Primary Care; Obesity Guidelines Overview; Obesity in Special Populations: The Elderly and Aging; Obesity in Special Populations: Young Adults and Adolescents; Obesity in Special Populations: Pregnancy and Peri-pregnancy, Including Epigenetics; Nutrition in Obesity Management: Cornerstones of Lifestyle Management; Physical Activity in Obesity Management: Cornerstones of Lifestyle Management; Behavioral Medicine and Counseling for Obesity; Obesity Pharmacotherapy; Medical Devices for Obesity Treatment; Bariatric Surgery for Obesity; Weight Maintenance and Long Term Management in Obesity; and Case Studies in Obesity Medicine.

Written by and for primary care professionals, this unique title presents step-by-step, evidence-based information for the assessment and treatment of patients who present with overweight or obesity. Highly practical and easy to use, Primary Care: Obesity helps you develop and hone the specific knowledge, skills, and clinical practices necessary to provide effective care to this highly prevalent and at-risk patient population. This comprehensive guide is an essential resource for today’s internal medicine and family medicine physicians, pediatricians, nurse practitioners, physician assistants, and other healthcare professionals who practice outpatient primary care.

This book reviews quality definition, measurement, improvement, value, and accountability for obesity management. The interplay between quality, cost, access and satisfaction is fully depicted with a goal toward not only fulfilling current standards but also anticipating future needs. A thorough inventory of current best practices in all aspects of obesity care is cataloged with a gap analysis also employed for potential areas of improvement to be road mapped. All chapters are written by experts in their fields and include the most up-to-date scientific and clinical information, take home messages, and questions towards following the requirements of quality certification in obesity management. Quality in Obesity Treatment provides a comprehensive, contemporary review of this field and serves as a valuable resource for Bariatric Surgeons, Primary Care Physicians, Policy Makers, Insurance Administrators, Bariatricians, and any medical specialty interested in obesity quality management with likely candidates coming from GI, endocrinology, cardiology, sleep medicine and orthopedics.