This content is taken from the IAPAM’s Medically Supervised Weight Loss training program. The program is designed to help physicians incorporate a medical weight loss program into their medical practice.
According to the National Institutes of Health (NIH), treatment of an overweight or obese person incorporates a two-step process: assessment and management. Assessment includes determination of the degree of obesity and overall health status. Management involves not only weight loss and maintenance of body weight, but also includes measures to control other risk factors. Obesity is a chronic disease; patient and practitioner must understand that successful treatment requires a lifelong effort. Convincing evidence supports the benefit of weight loss for reducing blood pressure and lowering blood glucose.
Overweight and obesity are serious and growing health problems, and are not receiving the attention they deserve from primary care practitioners. Among the reasons cited for not treating overweight and obese patients, is the lack of authoritative information to guide treatment. This Practical Guide to the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults was developed cooperatively by the North American Association for the Study of Obesity (NAASO) and the National Heart, Lung, and Blood Institute (NHLBI). It is based on the Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: Evidence Report developed by the NHLBI Expert Panel and released in June 1998. The Expert Panel used an evidence-based methodology to develop key recommendations for assessing and treating overweight and obese patients. The goal of the Practical Guide is to provide you with the tools you need to effectively manage your overweight and obese adult patients in an efficient manner.
Managing overweight and obese patients requires a variety of skills. Physicians play a key role in evaluating and treating such patients. Also important are the special skills of nutritionists, registered dietitians, psychologists, and exercise physiologists. Each health care practitioner can help patients learn to make some of the changes they may need to make over the long term. Organizing a “team” of various health care practitioners is one way of meeting the needs of patients. If that approach is not possible, patients can be referred to other specialists required for their care.
Who succeeds in maintaining weight loss? A conceptual review of factors associated with weight loss maintenance and weight regain.
Source: Obesity Reviews: an official journal of the International Association for the Study of Obesity, 2005 Feb; 6(1): 67-85
According to our review, successful weight maintenance is associated with more initial weight loss, reaching a self-determined goal weight, having a physically active lifestyle, a regular meal rhythm including breakfast and healthier eating, control of over-eating and self-monitoring of behaviors. Weight maintenance is further associated with an internal motivation to lose weight, social support, better coping strategies and ability to handle life stress, self-efficacy, autonomy, assuming responsibility in life, and overall more psychological strength and stability. Factors that may pose a risk for weight regain include a history of weight cycling, uninhibited eating, binge eating, more hunger, eating in response to negative emotions and stress, and more passive reactions to problems.