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About 70% of American adults are overweight or have obesity. Obesity is a chronic, relapsing, progressive disease associated with severe complications and comorbidities. Excess weight places people at higher risk of chronic diseases, including type 2 diabetes, heart disease, kidney disease, stroke, and certain cancers. However, research shows that even a modest weight loss of 5% to 10% of total body weight can result in health benefits. Patients with overweight or obese may want help setting and reaching weight-loss goals but may have difficulties talking about their weight. By speaking with these patients respectfully and working with them as partners, practitioners play a crucial role in empowering patients to improve their health. This activity describes strategies for counseling patients with overweight and obesity and highlights the part of the interprofessional team in evaluating and treating patients with this chronic disease. Objectives: Explain the importance of counseling patients with overweight and obesity. Identify the patient population who would benefit most from counseling on overweight and obesity. Summarize the barriers to counseling patients on overweight and obesity. Describe the strategies to counsel patients with excess weight and/or weight-related health comorbidities. Access free multiple choice questions on this topic.

Obesity is an increasing global challenge for healthcare providers. According to the World Health Organization, the worldwide prevalence of obesity has nearly tripled since 1975, with more than 1.9 billion adults overweight and 650 million with obesity in 2016.[1] Obesity is associated with a lower life expectancy. It is a risk factor for several chronic diseases, such as hypertension, coronary heart disease, and diabetes, as well as a range of mental disorders.[2][3][4] Many individuals with obesity experience discrimination and stigmatization.[5] Global healthcare costs for patients with obesity are approximately 30% higher than for individuals without obesity.[6][7] The literature demonstrates the importance of the physician-patient relationship and frequent clinical interactions in improving patient outcomes in obesity, including adherence to medications, higher motivation, and uptake of preventative care activities.[8][9][10] Therefore, healthcare practitioners must develop a framework and utilize proper tools to counsel their patients and improve their communication regarding weight management. Specific barriers exist within the medical community related to counseling patients with overweight or obesity. Many clinicians do not think counseling is feasible for various reasons, including time constraints and lack of appropriate training.[11] Additionally, studies show that healthcare practitioners have negative attitudes toward patients with excess weight and often blame psychological and behavioral factors as the root causes of obesity.[12][13] Negative attitudes and biases in the healthcare setting towards patients with overweight and obesity have detrimental effects on these high-risk patients who are vulnerable while seeking care and recommendations for health promotion. These findings emphasize the need for improvements in medical education and communication about excess weight.

Managing excess weight is challenging and complex and requires an interprofessional team approach that includes clinicians, nurses, pharmacists, dieticians, and nutritionists. While once a condition relegated to the domain of the primary care provider, it is now realized that weight management requires the expertise of a collaborative interprofessional team with an individualized patient-centered approach. To achieve optimal clinical outcomes, the patient and the healthcare team must discuss, mutually define, and agree upon the healthcare goals. Many studies have identified barriers to managing obesity, including lack of training, time, resources, and knowledge. One study cites that 45% of clinicians do not feel qualified to treat obesity.[45] For patients who are overweight or obese, nearly 50% have received education on weight loss, 50% on diet education, and 41% on exercise counseling.[46] Strategies for the health care team to improve the care of patients with obesity include regularly measuring BMI, routinely assessing patients' readiness for behavioral change, and training team members on the 5A model of patient counseling so that each member can participate in all or some of the five skills of the weight management plan. Evidence-Based Approach

Managing excess weight is challenging and complex and requires an interprofessional team approach that includes clinicians, nurses, pharmacists, dieticians, and nutritionists. While once a condition relegated to the domain of the primary care provider, it is now realized that weight management requires the expertise of a collaborative interprofessional team with an individualized patient-centered approach. To achieve optimal clinical outcomes, the patient and the healthcare team must discuss, mutually define, and agree upon the healthcare goals. Many studies have identified barriers to managing obesity, including lack of training, time, resources, and knowledge. One study cites that 45% of clinicians do not feel qualified to treat obesity.[45] For patients who are overweight or obese, nearly 50% have received education on weight loss, 50% on diet education, and 41% on exercise counseling.[46] Strategies for the health care team to improve the care of patients with obesity include regularly measuring BMI, routinely assessing patients' readiness for behavioral change, and training team members on the 5A model of patient counseling so that each member can participate in all or some of the five skills of the weight management plan. Evidence-Based Approach An interprofessional team that provides a holistic and integrated approach to weight management will achieve the best possible clinical outcomes. For example, referrals to a health coach or dietician are beneficial if a patient has specific dietary questions. Referrals to psychology with eating disorder expertise are essential for patients with eating disorders. For patients with physical limitations, referrals to physical therapy are often necessary. Other interdisciplinary team members can include bariatric endocrinology, integrative cardiology, gastroenterology proceduralists, and bariatric surgeons. Each can collaboratively help guide the patient toward better health and effective weight loss. Pharmacists can counsel patients and check for drug interactions if medication is part of the management strategy. Collaboration, shared decision-making, and open communication are critical elements for optimal outcomes. The 5A strategy represents one well-studied model that effectively guides patients toward their weight loss goals. The interprofessional care provided to the patient must use an integrated care pathway combined with an evidence-based approach and good communication between the team members and the patient.