Using the Best Tools to Combat Obesity

Obesity rates — and associated patient suffering and societal costs – are climbing, despite the fact that biomedical and public health experts better understand the causes and have more tools to combat it.

A group of the nation’s thought leaders, including physicians, researchers, government policy makers, industry leaders, and insurance representatives, met in Washington, DC, at the Consensus Conference of Obesity to discuss lifestyle intervention improvements, new pharmaceuticals, and bariatric surgery refinements. As a result of their discussions, the group produced an evidence-based, multi-dimensional, comprehensive consensus statement as a framework for a “concerted action plan” to conquer the obesity epidemic.

The 9-page executive consensus statement summary contains 3 types of information:

• Affirmed concepts generally accepted by the scientific and medical communities
• Emergent concepts identified during the conference’s discussions
• Key findings from the ground-breaking event

The statement’s affirmed concepts are that obesity is a chronic disease; clinicians should follow the American College of Endocrinology (AACE)/American Association of Clinical Endocrinologists (ACE) obesity algorithm, located on page 4 of their 2013 Diabetes Management Algorithm; comprehensive treatment plans must include lifestyle intervention; clinicians collectively need to reduce environmental obesogenic factors, such as low physical activity, high screen time, low fruit and vegetable intake, high soft drink consumption, and high snack intake; and primary and secondary prevention strategies are critical.

However, the statement’s 5 emergent concepts may be less familiar to clinicians. They included:

• The definition of obesity must be improved. Body mass index (BMI) may predict risk as a single metric, but it fails to reflect weight gain’s impact on individual’s health or well being.
• Different organizations require different thresholds of evidence based on specific mandates and decision processes. Inconsistencies hinder a concerted, uniform action plan that would make effective treatment modalities available consistently to all at-risk populations.
• Employees often lack access to obesity interventions because of insurance restrictions. Public awareness can change private reimbursement strategies and health care coverage.
• Healthcare professionals must engage in intergenerational obesity prevention. This demands intervention with children beginning at a very young age, as well as with pregnant women.
• Professionals must use approaches that underscore obesity care’s value rather than cost to patients, physicians, payers, and employers.

The consensus statement ended with key findings emphasizing how defining obesity as a chronic disease, practicing preventive medicine, and using a combination of biomedical and public health models demonstrate true value in obesity treatments.