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'More aggressive' obesity treatment urged for physicians

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WASHINGTON — During a discussion at the Consensus Conference on Obesity, experts examined the optimal use of therapeutic modalities and agreed that an intensification of treatment may be necessary.

Several common issues arose as more than a dozen medical professionals shared their input on the topic, including a need to develop a model of approaching the disease of obesity in a manner that has been as effective in bringing other diseases to the forefront of medical practitioners, as has occurred with hypertension and diabetes.

Yehuda Handelsman

Daniel Einhorn, MD, FACP, FACE, president of the American College of Endocrinology, said clinicians “need to be more aggressive” in addressing obesity with their patients.

“The main reason people quit smoking is because their health care professional talks to them about it,” he said. “There is no one direction and there is no one moment. You have to do whatever you can muster in your own community and continue to do it over time.”

Yehuda Handelsman MD, FACP, FACE, FNLA, medical director and principal investigator of the Metabolic Institute of America in Tarzana, Calif., made similar comments. “We did obviously agree that healthy lifestyle is the best modality … [and that] we need to intensify treatment. That could mean we combine medication with lifestyle, combine medication with surgery, but … the data is quite lacking on when to use a combination [and] how to use a combination.”

Use of BMI in defining obesity was discussed as problematic to many clinicians because comorbidities may not correlate to BMI, and sex and racial differences are not included in its calculation.

Solveig Cunningham, PhD, of the Rollins School of Public Health at Emory University, said defining a standard course of treatment is challenging. “We don’t have simple guidelines. It’s not as easy as saying, ‘Just don’t smoke.’” -- by Shirley Pulawski

For more information:

Presented at: The AACE/ACE Consensus Conference on Obesity; March 23-24, 2014; Washington, D.C.                                                                                     

Disclosure: The consensus conference is supported by Covidien, Eisai, Ethicon, Novo Nordisk, Takeda and Vivus.