Weight loss can be achieved through a variety of modalities, but long-term maintenance of lost weight is much more challenging. Obesity interventions typically result in early weight loss followed by ...a weight plateau and progressive regain. This review describes current understanding of the biological, behavioral, and environmental factors driving this near-ubiquitous body weight trajectory and the implications for long-term weight management. Treatment of obesity requires ongoing clinical attention and weight maintenance-specific counseling to support sustainable healthful behaviors and positive weight regulation.
Although widely recognized as a chronic disease that requires long-term, structured, and multidisciplinary management, obesity remains largely underdiagnosed and undertreated. The prevalence of ...obesity continues to increase dramatically, with the highest rates seen in the United States. Despite the availability of several clinical practice guidelines, published studies suggest that health care professionals (HCPs) infrequently and inconsistently follow guideline recommendations. Barriers to HCP participation in obesity management are likely to inhibit obesity counseling in primary care. Improving HCP obesity-related practices and counseling is important. This article discusses current practices, barriers to effective obesity management, and recommendations to improve HCP obesity management and counseling, based on findings from a PubMed search and clinical experience. The aim of the article is to share best-practice strategies for engaging patients.
The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, ...general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, ...general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
Objective
The objective of this study was to assess health care professionals' knowledge of evidence‐based guidelines for the nonsurgical treatment of obesity.
Methods
A nationally representative ...sample of internists, family practitioners, obstetricians/gynecologists, and nurse practitioners completed a web‐based survey between June 9 and July 1, 2016 (n = 1,506).
Results
Only 16% of respondents indicated that obesity counseling should be provided approximately twice monthly in an individual or group setting for at least 6 months, in accordance with United States Preventive Services Task Force and Centers for Medicare and Medicaid Services guidelines. Only 15% of respondents identified BMI ≥ 27 kg/m2 with an obesity‐associated comorbid condition as the appropriate indication to prescribe pharmacotherapy for patients. Two‐thirds of respondents indicated that it is appropriate to continue long‐term pharmacotherapy under conditions inconsistent with evidence‐based guidelines, with nearly one‐quarter indicating that obesity medications should never be prescribed beyond 3 months regardless of weight loss.
Conclusions
These findings suggest that provider understanding of appropriate clinical care for obesity is inconsistent with evidence‐based recommendations. As coverage for behavioral counseling services and pharmacotherapy expands, it is imperative that health care professionals understand how to effectively leverage these treatment modalities to optimize health outcomes for patients with obesity.
The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, ...general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, ...general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, ...general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
Objective
Dietary supplements and alternative therapies are commercialized as a panacea for obesity/weight gain as a result of the minimal regulatory requirements in demonstrating efficacy. These ...products may indirectly undermine the value of guideline‐driven obesity treatments. Included in this study is a systematic review of the literature of purported dietary supplements and alternative therapies for weight loss.
Methods
A systematic review was conducted to evaluate the efficacy of dietary supplements and alternative therapies for weight loss in participants aged ≥18 years. Searches of Medline (PubMed), Cochrane Library, Web of Science, CINAHL, and Embase (Ovid) were conducted. Risk of bias and results were summarized qualitatively.
Results
Of the 20,504 citations retrieved in the database search, 1,743 full‐text articles were reviewed, 315 of which were randomized controlled trials evaluating the efficacy of 14 purported dietary supplements, therapies, or a combination thereof. Risk of bias and sufficiency of data varied widely. Few studies (n = 52 16.5%) were classified as low risk and sufficient to support efficacy. Of these, only 16 (31%) noted significant pre/post intergroup differences in weight (range: 0.3‐4.93 kg).
Conclusions
Dietary supplements and alternative therapies for weight loss have a limited high‐quality evidence base of efficacy. Practitioners and patients should be aware of the scientific evidence of claims before recommending use.
The rationale for developing a certification in the United States is supported by the following key points: · The increased prevalence and burden of overweight and obesity among US adults and ...children present an important public health challenge that requires an expanded and dedicated physician workforce (1,2). · Obesity has recently been recognized as a chronic disease by several healthcare organizations, including the American Medical Association (3). · Steep increases in severe, complicated, and recalcitrant obesity demand specialist referral options for more advanced care. · Certification would bring increased recognition and competency to the obesity field and may lay the foundation for improved reimbursement for obesity care. · Offering a certification examination would increase the number of physicians choosing to train in obesity and/or seek obesity-related continuing medical education activities. · Anticipated advances in obesity care over the next decade in pharmacotherapy, surgical procedures, and devices will require specialty training and expertise. · There are an insufficient number of physicians to provide perioperative care for the increasing number of patients undergoing bariatric surgery and placement of medical devices for obesity treatment. · Certified physicians can serve as clinical and educational champions at the local and national level. · Board certification would establish minimal standards of appropriate knowledge and professional practice in obesity medicine. Origins of the ABOM Based on these arguments, the ABOM was established through the cooperative efforts and merger of two prior certification pathways- the American Board of Bariatric Medicine and Certified Obesity Medicine Physician-and incorporated as a...
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