For millions of Americans battling obesity, the biggest obstacle to weight loss and wellness is not whether they can stick to a diet or exercise regularly, but overcoming the bias they encounter at their own doctor’s offices.
From blood pressure cuffs and scales designed for adults who do not have obesity, to the lack of resources and limited advice from doctors, patients with obesity often feel abandoned and stigmatized by a medical system that isn’t properly educated about long-term, scientific-based treatment therapies for obesity.
“An overwhelming percentage of my patients report experiencing some form of mistreatment within our current health care system, whether that be outright shaming or dismissal of obesity and related medical problems,” said Jenny Seger, MD, FOMA, an obesity medicine physician from San Antonio, Texas. “To have obesity in America often makes individuals the target of bullying and mistreatment. I believe it is the last acceptable form of discrimination in this country.”
One of Seger’s patients, Marissa Helm from San Antonio, summed up the frustration many patients feel.
“One of my primary frustrations about my weight loss is that it took so long for a doctor to give me the information and education I needed to make the right choices about my diet and exercise,” she said. “It’s not like I had only been a little overweight for a short period. I had obesity for over a decade, and none of my doctors—general practitioners, OB/GYN, rheumatologist, etc.—ever gave me any information like what Dr. Seger provided.”
Seger is a member of the Obesity Medicine Association, a group of clinicians specially trained in treating obesity using a scientifically proven approach.
The Obesity Medicine Association this week released a set of obesity guidelines to better prepare health care providers to treat patients with obesity. Seger is one of many obesity medicine clinicians who co-authored these obesity guidelines, titled the Obesity Algorithm.
The 2017 Obesity Algorithm is the latest version of the association’s obesity guidelines, published originally in 2013 and updated yearly since then. Key updates in the 2017 version include advice on non-stigmatizing language doctors can use with patients as well as specific guidelines for patient-friendly furniture and office equipment.
“Clinicians and staff should be trained to avoid hurtful comments, jokes, or otherwise being disrespectful, as patients with obesity encounter this type of bias everywhere else,” said Harold Bays, MD, an obesity medicine physician from Louisville, Ky., and a co-author of the Obesity Algorithm.
Bays and his co-authors compiled a list of positive office-space recommendations, such as: providing sturdy‚ armless chairs and extra-large patient gowns. The obesity guidelines advise that physician offices be equipped with large adult blood pressure cuffs or thigh cuffs for patients with an upper-arm circumference greater than 34 cm and weight scales with the capacity to measure patients who weigh more than 400 pounds.
“Weight loss is among the most common New Year’s resolutions for patients who have obesity and who want to improve their health,” said Bays. “To help providers better meet the needs of their patients with obesity, especially when patients make health resolutions, we intended to provide clinicians with a unique resource that is comprehensive in context, scientifically based with substantial updates, and highly focused on the practicalities of clinical obesity management.”
The Obesity Medicine Association believes so strongly in this mission, they make the Obesity Algorithm available for free to any health care professional.
Additional updates to the 2017 Obesity Algorithm include the science and function of hormones that control digestion, an expanded section on FDA-approved surgical procedures, an increased focus on nutrients after bariatric surgery, and the importance of bacteria in the digestive system. Obesity genetic syndromes are also discussed.
“We have attempted to clarify some of the more sentinel and challenging topics in obesity medicine, including the obesity paradox—where someone can have excess weight or obesity but still be metabolically healthy,” said co-author Craig Primack, MD, FOMA, an obesity medicine physician from Scottsdale, Ariz. “We also included body composition and energy expenditure assessments, as well as a description of many of the most common diet patterns.”
Click here for more information or to download a free copy of the 2017 Obesity Algorithm.