Since the 1980s the CDC has been tracking state-level rates of obesity, despite numerous local efforts to alter food and activity environments, the rates of obesity have remained high and in some cases are continuing to climb. Local governments, Federal policymakers, employer groups, and health systems have programming offering behavioral approaches to address obesity, and in health systems, medical and surgical options are on offer, but the ability to access services is highly variable.
The STOP Obesity Alliance have just published a proposed set of standards for obesity care in the latest issue of the journal Obesity. The standards were developed by a multi-disciplinary group of stakeholders, including health care providers and payors, community and commercial leaders of weight management programs and policymakers.
Fundamental core principals include the following:
-Obesity should be treated as a chronic disease.
-Care should be evidence-based, pragmatic, and deliverable.
-Patients deserve access to appropriate levels of care, regardless of their point of entry to the health care system.
-Providers should be sensitive to bias and language and make accommodations for patient care (i.e., adequate furniture, equipment, and an environment that accommodates a patient’s needs
-Providers should be trained to initiate the conversation about weight and weight change with patients to assess willingness to address their obesity.
-Shared decision‐making and bidirectional communication between individuals and providers are essential. Providers need to be aware of and refer to the full range of appropriate treatment services for obesity.
-Evidence‐based competencies that are discipline specific should be met by each type of provider
-Social determinants of health should be considered when developing a treatment plan, taking into consideration patients’ home, work, and community environments; interpersonal relationships and family dynamics; stressors; and cultural preferences.
(Source – https://onlinelibrary.wiley.com/doi/full/10.1002/oby.22507)
The standards are broad and will require collectively coordinated partnerships if they are to be realized. Efforts to date have gone part way to building strong foundations, but much more is needed to ensure people with obesity have access to the level of care and service to support their customized care plan.
These standards are a welcome step in the right direction. Since the Affordable Care Act (ACA) was passed in 2010, the standard of behavioral weight management has shifted more to the appropriate levels if intensive behavioral therapy levels also called for by the grade B recommendation but the US Preventative Services Task Force (USPSTF). The recent coverage of the Medicare Diabetes Prevention Program (MDPP) also means more people have access to evidence-based weight management programs. At its core, the standards also call out weight bias with is pervasive in society and can also enter into the patient-provider relationship, ensuring training to raise awareness and reduce stigma is also an essential addition to this clinical area.
Thanks for reading – Trina
(Opinions are my own)
References
A proposed standard of obesity care for all providers and payers
https://onlinelibrary.wiley.com/doi/full/10.1002/oby.22507
USPSTF Grade B Recommendation for Obesity
https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/obesity-in-adults-interventions1
Medicare Diabetes Prevention Program
https://innovation.cms.gov/initiatives/medicare-diabetes-prevention-program/
