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Obesity Treatment, Beyond the Guidelines: Practical Suggestions for Clinical Practice

Kahan S, Manson JE. Obesity Treatment, Beyond the Guidelines: Practical Suggestions for Clinical Practice. JAMA. Published online March 21, 2019. doi:10.1001/jama.2019.2352

An “ABCDEF” Approach

The potential benefits of compassionate, coordinated obesity treatment are clear. (…) Several practical strategies could be helpful to structure an approach to obesity management in clinical practice, using a convenient “ABCDEF” framework. (…) Ask “permission” before discussing obesity. (…) Be systematic in the clinical workup. Advising patients to “just eat less and exercise more” is unhelpful. (…) Counseling and support improve weight loss perceptions (…) and outcomes. (…) Determine health status. (…) Escalate treatment when appropriate. (…) Follow up regularly and leverage available resources. Obesity will not be solved in a single clinic visit. (….) Clinicians should offer support and monitor weight and other metrics, such as changes in waist circumference and weight-related risk factors, as well as subjective improvements in energy, mobility, and chronic pain symptoms. Frequent counseling is essential. (…) Attempts to achieve effective obesity management will be frustrating at times, both for patients and clinicians alike.

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