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Tag: overweight

Weight Loss Counseling? Not So Much.

Adults who are overweight or obese report receiving little weight loss counseling, especially involving medications and surgery; however, many report trying to lose weight within the last 12 months, according to a speaker at ObesityWeek. 

“We know that less than 50% of patients with obesity have reported receiving weight loss counseling within a provider visit and most providers, primary care providers, provide no counseling at all,” Sean J. Iwamoto, MD, a postdoctoral fellow in the division of endocrinology, metabolism & diabetes at the University of Colorado School of Medicine, Anschutz Medical Campus, said during his presentation. “At baseline it seems that primary care providers seem to overvalue exercise, meaning they find its more comfortable to discuss exercise with their patients, as well as they feel it’s the most effective way to lose weight, and they undervalue other things like weight loss medications. We also know that obesity medications are effective but prescription rates are low.”

Iwamoto and colleagues evaluated data from the Patient Outcomes Research to Advance Learning (PORTAL) on 2,811 adults (median age, 52 years; 54.2% white; 61.8% women; 79.4% with obesity) to determine weight-related health care experiences. Participants completed a survey in the summer of 2015 to report on personal experiences from providers.

Among participants with obesity, 79.8% tried to lose weight in the last 12 months, more than half exercised or changed eating habits and less than 9% used weight loss programs or medications. Fewer than 3% had weight loss surgery.

Participants reported that their health care providers only sometimes (49.5%) or never (17.1%) brought up weight at clinic visits. Discussions about lifestyle change (83.7%) and weight loss programs (62%) were reported more often than meal replacements (19.2%), surgery (15.6%) or medications (10.6%).

“Overall, most patients with overweight and obesity have tried to lose weight by changing eating habits and exercising, very few have tried medications, weight loss programs and surgery,” Iwamoto said. “Also, they have received little information about medications and surgery even when its indicated.”

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Most Cardiologists Lack Nutrition Education

A recent study has found that the majority of cardiologists lack current, up-to-date education surrounding nutrition and diet. A report published by the American Journal of Medicine, authored by a dozen healthcare professionals in the United States and Spain, titled “A Deficiency of Nutrition Education and Practice in Cardiology” details that less than a third of cardiologists describe their nutrition knowledge as “mostly up to date” or better.

Although the leading cause of premature death and disability in the United States is heart disease, most cardiologists report inadequate training in nutrition. “Using nutrition as medicine is probably one of the most cost effective ways to treat disease but is incredibly underutilized by healthcare providers,” explained Andrew Freeman, M.D., a cardiologist at National Jewish Health in Denver, and one of the study’s co-authors. “If we could empower healthcare providers with information on how to implement this in daily practice, we could transform healthcare rapidly, prevent healthcare cost explosions, and reduce morbidity and mortality.”

Ninety percent of cardiologists surveyed reported receiving no or minimal nutrition education during cardiovascular fellowship training; 59 percent reported no nutrition education during international medicine training; 31 percent reported no nutrition education throughout medical school. Almost two-thirds of all surveyed cardiologists reported spending three minutes or less per visit discussing nutrition with their patients.

The report further noted that the total annual cost related to heart and vascular diseases in the United States is $315 billion, much of which could be lessened with proper nutritional training and implementation.

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