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Physicians must acknowledge, accept multiple methods to treat obesity
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WASHINGTON — Most experts here said they agreed that lifestyle intervention is key to management of obesity in our society, but they expressed the need for cooperation between treatment modalities and disciplines, as well as the data to confirm efficacy.
“If obesity is to be considered a chronic disease, then you need every tool that you can muster for management,” Daniel Einhorn, MD, FACP, FACE, who co-moderated the health industry and economics session, said during the Consensus Conference on Obesity. “Drawing from the diabetes model, the use of medication in diabetes is not seen as a failure on anybody’s part. It’s simply part of what is required to get the desired outcome. We think that is very important in the obesity space.”
Jeffrey I. Mechanick
In addition, Susan Kansagra, MD, MBA, deputy commissioner for health promotion and disease prevention of the New York City Department of Health and Mental Hygiene, said the consensus committee should consider population-level changes and the effect they could have on overall obesity.
“I want to challenge the audience to think not just in a medical-clinical environment but to think a little bit more broadly at the population level. A lot of the evidence for [smoking] interventions came after they were implemented, so we should acknowledge that there might be a research gap now, but there are other methods of evaluating those types of environmental changes,” Kansagra said. “Within the last 30 years, it’s not the individuals that have changed, it’s our environment and especially our food choices.”
Ann Albright, PhD, RD, of the CDC, supported Kansagra’s statement.
“We do need to try some of those. We call them natural experiments,” Albright said. “We need to put them into place and see what happens.”
Jeffrey I. Mechanick, MD, FACN, FACP, FACE, ECNU, co-chair of the conference and AACE president, summarized the discussion: “There are a lot of different therapeutic options, and it’s a much larger spectrum than just conventional lifestyle, drugs and surgery that patients can be free to explore, but obesity experts should be utilized in that decision mechanism to at least be able to guide that use.” -- by Katrina Altersitz
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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.