News: Featured Stories

September 2, 2015

New guidelines established to help primary care physicians treat obese patients


  • Medical School
Behavioral experts at UMMS create framework to aid PCPs with identifying patients in advance who need extra support.

Primary care physicians have a significant opportunity to address obesity during visits with patients; however, time constraints require that counseling be must be brief, targeted, and effective, according to UMass Medical School experts. 

In a paper published online in the American Journal of Medicine, Sherry Pagoto, PhD, associate professor of medicine, Lori Pbert, PhD, professor of medicine, and colleagues outline a model to provide PCPs with practical guidance on how to maximize obesity treatment during visits and identify patients who might require additional support. 

“Primary care is a health care entry point for many patients. However, PCPs have very limited time and don’t always have training in obesity management since it is an emerging discipline,” said Dr. Pagoto. “We wanted to create a simple guide to help the PCP oversee the treatment of obesity while leveraging other health care providers and community resources.”

Several entities, including the U.S. Preventive Services Task Force, the American Heart Association, American College of Cardiology and the Obesity Society, have recommend that physicians screen for overweight and obesity in their practice and then provide intensive behavioral counseling to patients with risk factors for cardiovascular disease. However, the rates of screening and counseling for obesity in the primary care setting are only 30 percent, according to Pagoto.

With more than two-thirds of US adults meeting the criteria for being obese or overweight and with excessive weight being linked to cardiovascular disease, Type 2 diabetes and several cancers, Pagoto noted it is critical that a counseling framework include a way to identify patients that have high risk of treatment failure, so that strong supports can be put in place.

“What makes these guidelines unique is that these are the only guidelines that help PCPs identify in advance the patients who are not likely to do well in usual care so that he or she can construct a treatment plan that will better set these patients up for success,” Pagoto said.

The guide also helps PCPs connect patients with available allied health care providers and community resources and offers suggestions on how to counsel them on ways to succeed in their goal by using an approach called the 5 A’s: assess, advise, agree, assist and arrange.

“The PCP doesn’t have to take on obesity management alone, but rather can construct and oversee a team that has all the necessary expertise to help the patient be as successful as possible,” she said.

More on the guidelines can be found in the American Journal of Medicine