Physicians Role In the National Obesity Crisis

Every practicing primary care physician in America sees overweight patients daily.  With 68% of America being overweight, there is zero likelihood that you do not encounter patients with weight control issues.  Moreover, you are 100% likely to be treating patients for weight related co-morbidities such as hypertension, diabetes, hypercholesterolemia, sleep apnea, GERD etc. You are prescribing medications to treat these aforementioned problems.  

I have no doubt that most physicians advise their overweight patients to lose weight.  Having said that, it should be noted that a number of studies demonstrate that a certain percentage of overweight patients report that their physicians never say a word about their weight control problem.  What are our responsibilities as physicians in this national healthcare crisis?

First, although this is not really an “excuse”, I will blame the lack of physician attention to those “friends of ours” (this is not in the Godfather vernacular meaning a “made wiseguy”) at the insurance companies.  For those physicians participating with insurers, you are forced to see many patients in a short period of time because of the reduced rates paid by the companies.  There is precious little time to discuss preventative strategies with the patients.  Perhaps you only have enough time to write their prescriptions and advise them to “eat less and exercise more”.  Would it be great to have a nutritionist or nurse practitioner on site to consult with overweight patients?  You bet it would, but how would you pay this person?  The insurance companies aren’t exactly offering you any help with your payroll.

Some physicians take the time to hand the patient dietary sheet or other educational handouts.  But is this enough?  Obviously, your patients’ success in losing weight will allow you to reduce or perhaps even discontinue medications prescribed for the co-morbidities.  Your patients’ confidence and self-esteem will improve as they are becoming healthier.  They will look younger and have more energy.

My belief is that you have two choices:  Implement a weight loss program in your practice or refer your patients to a physician who offers a reputable program.  I am obviously biased as I operate the Serotonin-Plus Weight Loss Program, which bases dietary plans on real food as opposed to shakes, bars and/or meal replacements.  I believe any reputable weight loss program must be based on behavior modification and not centered on selling things to the patients.

If losing weight was easy and help was not needed, the majority of Americans would not be overweight.  Your overweight patients need help and if you cannot provide this help then I believe you are obligated to send them somewhere that will provide a solution.  As an aside, if you offered them help, you could develop an incredible ancillary stream of revenue to your practice, but business aside, your patients rely on you for direction.  If you have little or no involvement, then your patients will resort to buying supplements off the internet, purchasing prepackaged foods that will only help their efforts short term, or wander into weight loss clinics which may be all about making money by selling their shakes and bars.

As physicians, we are mostly trained to treat disease states. I believe our role needs to change to be more proactive in prevention.