Role of Healthcare Providers

April 14th, 2024
Written By Essohanam Aimee Edjeou-Bah

Photo by AI Creator.

What is obesity?

Obesity is a complex health issue that requires preventive measures and early intervention, and it would be helpful to know how healthcare providers are navigating this challenge. It is interesting to learn that there is a difference between being obese and being overweight, as being obese means having a lot of fat in the body, while being overweight is more related to muscle mass. It is important to understand this difference and how it impacts our health. I also wonder how informed healthcare providers are about obesity and how they communicate this information to patients in an effective manner.

In the healthcare field, per the National Institute of Diabetes and Digestive and Kidney Diseases, “Talking with your patients about weight,”  it is essential to understand this distinction and consider various factors, such as age, medical history, and race, when evaluating BMI and waist size. While it may be difficult for patients to broach this subject with their healthcare providers, it is imperative for their overall health and wellness. I am glad to hear that nutritionists also recognize the importance of addressing this issue.

Effects of obesity

The best healthcare providers to address the weight issues of patients are mostly their primary care providers. They are in a better position because the conversation can sometimes be challenging or uncomfortable. By having a respectful conversation, healthcare providers can assist and make the collaboration of patients easy (“crucial”).  Sometimes patients with obesity can benefit from discussions about weight loss, maintenance plans and programs, or even surgery, but they may find it hard to start the conversations. Healthcare providers need to provide a non-judgmental environment for patients to be comfortable with those discussions (Afton M. Koball et al.). Patients with a BMI of 30 or higher or a waist size of more than 35 inches for women and 40 inches for men may have metabolic syndrome, high blood pressure, unhealthy lipid levels, or high blood glucose levels (“metabolic”). Even though all that was named above does not directly measure the amount of fat in a patient’s body, patients need this information to make a crucial choice regarding their health.

   All this information is not enough data to assess the health risks related to excess body fat in all patients’ cases. Weight loss may not be the best for every patient (Kevin D. Hall, PhD, and Scott Kahan, M.D., MPH). Some might just need weight maintenance or some patients with a low BMI might even be at greater risk of health issues than those with a high BMI with illnesses such as hypokalemia, hyponatremia, hypophosphatemia, etc. The focus will be on the high BMI at this time. Sometimes patients get stigmatized regarding their weight. They may experience prejudice, negative attitudes, or even discrimination from other people, sometimes their healthcare providers. And that can make patients experience negative stigma, such as the increased risk of depression, lowering their self-esteem, stress, eating disorders, and social isolation.

Solutions

All this information is not enough data to assess the health risks related to excess body fat in all patients’ cases. Weight loss may not be the best for every patient (Kevin D. Hall, PhD, and Scott Kahan, M.D., MPH). Some might just need weight maintenance or some patients with a low BMI might even be at greater risk of health issues than those with a high BMI with illnesses such as hypokalemia, hyponatremia, hypophosphatemia, etc. The focus will be on the high BMI at this time. Sometimes patients get stigmatized regarding their weight. They may experience prejudice, negative attitudes, or even discrimination from other people, sometimes their healthcare providers. And that can make patients experience negative stigma, such as the increased risk of depression, lowering their self-esteem, stress, eating disorders, and social isolation.

According to research done at the Mayo Clinic, during pregnancy, it is important to be aware of the potential risks that come with being overweight or obese. Research has shown that pregnant women who are overweight have a higher likelihood of developing health problems such as gestational diabetes, preeclampsia, and high blood pressure. These complications can lead to a c-section (caesarean section) delivery and pose risks during surgery and anesthesia. Furthermore, it’s worth noting that losing the weight gained during pregnancy can be challenging, and many women may even gain more weight during the breastfeeding period. Therefore, it is essential to prioritize healthy habits and maintain a healthy weight during pregnancy to reduce the risk of health complications (“Pregnancy”).

According to an Obesity Prevention source, the campaign for obesity prevention is a sum up of expert research from the American Academy of Pediatrics. Based on recent research on children, adding up clinical interventions to community implementation can help children adapt to changes but it does not help in “sizable improvement in weight”. “Randomized controlled trial to improve primary care to prevent and manage childhood obesity: the high five for kids’ study”. (Elsie M. Taveras, et al.)

 To understand what happens at the interpersonal level of healthcare facilities regarding consultations for people living with obesity, Luig argues that research has been conducted by directly observing consultations done by healthcare providers. The research was based on a one-on-one consultation between patients and healthcare providers, about their weight and the effects it has on the patients, and solutions were given to help improve their quality of life.

Nutritionists also recognize the importance of addressing weight management issues. According to an intriguing study published on PubMed Central that explored the effectiveness of a healthcare program called 5 As Team (Jodie Asselin, PhD et al.), this program, has been used by healthcare providers in the Primary Care Network to help patients manage their weight and prevent obesity. The study found that the program has been successful in providing patients with tailored support to improve their weight, while also giving healthcare providers the tools to better assist their patients in weight management. The study also highlighted that patients living with obesity were seeking a program that was specifically tailored to their needs, while healthcare providers were looking for ways to improve their patients’ weight management.

Conclusion

The 5As T approach has been designed with flexibility in mind, which has allowed healthcare providers to adapt the program based on their patients’ unique needs. In addition, the study identified two experiences in the PCN that helped to standardize the delivery of the program to patients, which has minimized variability in how the program is delivered. Overall, the study suggested that the 5As T program, defined as “ask, assess, assist, agree, and advise,”  is an evidence-based approach that can be effective in helping patients manage their weight and prevent obesity. It also provides healthcare providers with a valuable tool for better supporting their patients in weight management and offering tailored support to meet the unique needs of each patient.

Overall, healthcare providers need to work with their patients’ by effectively communicating all the information they acquire through each program put in place to help patients lose or manage their weight, according to patients’ health histories. Overall, obesity and overweight can affect anyone at any stage of their life. Using the 5As Team and following healthcare providers will be beneficial for patients living with obesity.

Works Cited

Alex H. Krist et al. “Engaging patients in decision-making and behavior change to promote prevention” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6996004/

John Hopkins Medicine “Metabolic Syndrome” https://www.hopkinsmedicine.org/health/conditions-and-diseases/metabolic-syndrome

Kevin D. Hall PhD and Scott Kahan M.D., MPH “Maintenance of lost weight and long-term management of obesity” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764193/.

Luig, Thea et al. “Understanding Implementation of Complex Interventions in Primary Care Teams.” Journal of the American Board of Family Medicine: JABFM vol. 31,3 (2018): 431-444. doi:10.3122/jabfm.2018.03.170273

Markle‐Reid, Maureen, et al. “Community Program Improves Quality of Life and Self‐Management in Older Adults with Diabetes Mellitus and Comorbidity.” Journal of the American Geriatrics Society (JAGS), vol. 66, no. 2, 2018, pp. 263–73, https://doi.org/10.1111/jgs.15173.

National Institute of Diabetes and Digestive and Kidney Diseases “Talking with your patients about weight” https://www.niddk.nih.gov/health-information/professionals/clinical-tools-patient-management/weight-management/talking-with-your-patients-about-weight

National Library of Medicine “Crucial conversations about eight management with healthcare providers: patients’ perspectives and experience” https://pubmed.ncbi.nlm.nih.gov/27473870/ (Koball et al)

“Pregnancy and obesity: Know the risks.” https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy-and-obesity/art-20044409

Telfer, Evelyn E et al. “Making a good egg: human oocyte health, aging, and in vitro development.” Physiological reviews vol. 103,4 (2023): 2623-2677. doi:10.1152/physrev.00032.2022

“Randomized Controlled Trial to Improve Primary Care to Prevent and Manage Childhood Obesity: The High Five for Kids Study.” Pubmed, 11 Apr. 2011, pubmed.ncbi.nlm.nih.gov/21464376/.

US Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Physical Activity Guidelines for Americans. 2nd ed.

US Department of Health and Human Services; 2018. Accessed May 23, 2022. https://health.gov/our-work/nutrition-physical-activity/physical-activity-guidelines/current-guidelines External link

US Preventive Services Task Force, Curry SJ, Krist AH, et al. Behavioral weight loss interventions to prevent obesity-related morbidity and mortality in adults: US Preventive Services Task Force recommendation statement. JAMA. 2018;320(11):1163–1171. doi:10.1001/jama.2018.13022

Wharton, Sean et al. “Obesity in adults: a clinical practice guideline.” CMAJ: Canadian Medical Association journal = journal de l’Association medicale canadienne vol. 192,31 (2020): E875-E891. doi:10.1503/cmaj.191707

Zhang and al. “Food Policy Approaches to Obesity Prevention: An International Perspective” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4333683/