Weight Management a Multistep Process
Weight Management a Multistep Process
Dec. 23, 1999 (Baltimore) -- Successful weight management is a process involving at least four components and should include the medical profession to help an individual improve their health, says Maria Collazo-Clavell, MD, author of a paper on weight management in the December issue of the Mayo Clinic Proceedings.
In an interview with WebMD, Collazo-Clavell says, "Many physicians do not address weight issues until a significant problem exists. We need to take a more active role in assessing body mass index (BMI)." BMI is weight in kilograms divided by the square of height in meters; overweight is a BMI of 25 to 29.9. Obesity is a BMI over 30.
Collazo-Clavell's paper takes the weight control recommendations of the National Institutes of Health and puts them into a more concise form that she hopes will aid primary care physicians in helping patients manage their weight. She says, "There are four cornerstones to weight management. These include dietary intervention, recommendations for physical activity, behavior modification, and for some patients, pharmacologic [drug] or surgical intervention.
"I think these are very good guidelines," says David Creel, MS, RD, director of the center for weight management at the Indiana University School of Medicine, in an interview with WebMD. "All four factors are equally important in developing a successful weight management program."
Before a physician recommends weight loss for a patient, other issues need to be addressed. "A multifaceted approach to the obese patient should include identifying potential causes for weight gain, outlining medical conditions that would benefit by weight loss [such as high blood pressure and cholesterol], and tailoring a weight loss program that is safe and effective for the individual," says Collazo-Clavell, who is an instructor of medicine at the Mayo Clinic.
"It is critical that physicians calculate the body mass index (BMI) of the patient," Collazo-Clavell says. "Sometimes patients come in who don't look especially overweight, but if the BMI is calculated it turns out that they are. Older weight guidelines are out of date and not as useful."
Collazo-Clavell says calculating BMI will help primary care physicians intervene early if a patient is gaining weight, before many of the health consequences of obesity catch up with the patient. "I emphasize with my patients that what's really important about weight is the health consequences. In the past, we would say to a patient 'You really need to lose weight,' then leave it up to the individual. We know now that the physician needs to be involved to help the individual improve their health."
Creel agrees that the health consequences of obesity need to be stressed, and adds, "I think it's especially important to address the behavioral component of the guidelines. We need to encourage patients to keep records on what they're eating, teach them how to manage cravings, and change the way they think about what they do. We must really get at the core of what's going on, how food is being managed, what the relationship to food is. We must also realize that this is a chronic problem. The guidelines indicate at least a six-month intervention for weight loss, but people who are overweight need to realize that this is a lifetime condition."
Weight Management a Multistep Process
In an interview with WebMD, Collazo-Clavell says, "Many physicians do not address weight issues until a significant problem exists. We need to take a more active role in assessing body mass index (BMI)." BMI is weight in kilograms divided by the square of height in meters; overweight is a BMI of 25 to 29.9. Obesity is a BMI over 30.
Collazo-Clavell's paper takes the weight control recommendations of the National Institutes of Health and puts them into a more concise form that she hopes will aid primary care physicians in helping patients manage their weight. She says, "There are four cornerstones to weight management. These include dietary intervention, recommendations for physical activity, behavior modification, and for some patients, pharmacologic [drug] or surgical intervention.
"I think these are very good guidelines," says David Creel, MS, RD, director of the center for weight management at the Indiana University School of Medicine, in an interview with WebMD. "All four factors are equally important in developing a successful weight management program."
Before a physician recommends weight loss for a patient, other issues need to be addressed. "A multifaceted approach to the obese patient should include identifying potential causes for weight gain, outlining medical conditions that would benefit by weight loss [such as high blood pressure and cholesterol], and tailoring a weight loss program that is safe and effective for the individual," says Collazo-Clavell, who is an instructor of medicine at the Mayo Clinic.
"It is critical that physicians calculate the body mass index (BMI) of the patient," Collazo-Clavell says. "Sometimes patients come in who don't look especially overweight, but if the BMI is calculated it turns out that they are. Older weight guidelines are out of date and not as useful."
Collazo-Clavell says calculating BMI will help primary care physicians intervene early if a patient is gaining weight, before many of the health consequences of obesity catch up with the patient. "I emphasize with my patients that what's really important about weight is the health consequences. In the past, we would say to a patient 'You really need to lose weight,' then leave it up to the individual. We know now that the physician needs to be involved to help the individual improve their health."
Creel agrees that the health consequences of obesity need to be stressed, and adds, "I think it's especially important to address the behavioral component of the guidelines. We need to encourage patients to keep records on what they're eating, teach them how to manage cravings, and change the way they think about what they do. We must really get at the core of what's going on, how food is being managed, what the relationship to food is. We must also realize that this is a chronic problem. The guidelines indicate at least a six-month intervention for weight loss, but people who are overweight need to realize that this is a lifetime condition."