It’s not only obese patients who are resistant to weight loss strategies. Many physicians contribute to the gap between current practice and optimal management of adult obesity, as well. There are a number of reasons for this—a dearth of knowledge, time, and reimbursement among them.
What’s more, physicians are often pessimistic about how much headway patients can make in their weight loss efforts.
The National Weight Control Registry
That’s not surprising, given that the average weight loss achieved in well-controlled clinical trials tends to be modest and the recidivism rate is extremely high. Yet these same trials are cause for optimism, with substantial subsets of patients often achieving clinically meaningful long-term weight loss.
The National Weight Control Registry, a long-term prospective study of “successful losers,” is another hopeful indicator. The registry includes approximately 6000 individuals who have lost, on average, more than 70 lb, and kept it off for an average of 6 years.
Weight loss does not have to be huge to be clinically significant. Even a modest loss (5%-10% of total body weight) can have major health benefits. There’s much you can do to help. Evidence suggests that patients are considerably more likely to lose weight when they are advised to do so and supported by their primary care physician.
Because there is no way to predict which approach will be most effective for which patient, family physicians (FPs) should offer a variety of evidence-based treatments, including dietary change, increased physical activity, medication for selected patients, and surgery for severely obese adults.
