A Patient-Centered, Evidence-Based Approach to Conquering Obesity – +3 Prize Points

by Jul 14, 2021Chronic Diseases, Community, Diabetes, Nutrition, Obesity, Physical Activity, Thomas George, Jr. DNP, CRNP, FNP-C

Losing weight is NOT the primary goal of treating obesity. The primary goals are to identify, address, and treat the underlying multifactorial contributors of obesity; weight loss is the outcome of successfully treating the causes of obesity. A patient-centered, evidence-based approach matches scientifically sound interventions to the unique needs of the whole person and their unique circumstances. The process begins with diagnosing and staging obesity. 

A body mass index (BMI) ≥ 30 is considered diagnostic for obesity for most people (and ≥ is considered as pre-obesity). The formula for BMI is based on weight and height and does not directly measure body fat or account for muscle mass. BMI is a useful tool for estimating and staging obesity, but measuring body composition and body fat percentage is more accurate for establishing the diagnosis of obesity. 

The next step is obtaining a thorough history, including eating habits, weight chart, medical conditions, surgical procedures, medications, family history, physical activity, and screenings for depression, anxiety, eating disorders, and adverse childhood events. A medication review will help identify any medications that could be contributing to obesity. A complete physical exam follows the history and focuses on identifying signs and symptoms for the over 200 conditions associated with obesity. Diagnostic testing is conducted to help identify any other contributing factors or consequences of obesity. Testing includes measuring the resting metabolic rate, body composition, vital signs with accurate height and weight, plus the laboratory studies of blood and urine. 

Once all the data is collected, the patient and provider review the findings and collaboratively develop an individualized plan of care with evidence-based interventions. The plan of care incorporates the pillars of obesity treatment: nutrition, physical activity, behavioral health, medication, and surgery when indicated. Mutually agreed-upon goals are established using the SMART framework (Specific, Measurable, Attainable, Relevant, and Time-Bound).

Successfully treating and reversing obesity requires a thoughtful, individualized plan of care that recognizes and considers the whole person…mind, body, and soul! The odds of success improve when a patient-centered, evidence-based approach is used…and even more so when patients are part of groups making the journey together. An old adage says “The journey of a thousand miles begins with a single step…” Are you ready to take the first step? You don’t have to do it alone. Contact me if you would like to be part of a like-minded tribe stepping in the same direction. Together, WE CAN DO THIS!

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