Treat pre-obesity with early intervention

Whether you’re a primary care provider or a specialist, you’re familiar with seeing patients with comorbidities, obesity and those with a BMI of 30 or greater. These patient populations are at a higher risk and require clinical support to navigate their health issues. But new studies suggest that we as providers can have a positive impact on patient outcomes when we take a more preventive approach prior to obesity.

Identifying the risks

Research shows the risk for increased chronic disease and mortality begins with a lower BMI. The Global BMI Mortality Collaboration Trial reported the relationship of BMI and all-cause mortality and cause-specific mortality has a J-shaped curve with the change point at a BMI of 25, or pre-obesity. Public health efforts have focused on a BMI of 30 and above, but highlighting this new BMI benchmark is a call to action for providers to intervene earlier and educate patients more thoroughly. This is particularly important as studies show many patients with pre-obesity will progress to obesity.

Lowering the screening metrics to patients with a BMI of 25 and above sets a precedent for providers to assess the metabolic, psychological and functional effects of an elevated weight on patients. This also empowers physicians to offer clinical guidance and emotional support from the get-go while ensuring that no patients fall through the cracks.

Treating patients with pre-obesity

Patients struggle with pre-obesity and obesity for a variety of reasons, including family history, lifestyle confines, preexisting conditions and psychological issues. That’s why treating patients with the disease is so complex and multifaceted. However, there are evidence-based strategies and chronic disease management techniques that can help patients see significant health improvement and avoid complications.

Here is some advice you may want to share with patients:

• Finding the right diet plan can help reduce calories.
• Keeping a detailed food diary may be helpful.
• Increasing physical activity can start with a little bit every day.
• Finding support groups both in person and online can be motivating.

Addressing the epidemic early

More than 73% of U.S. adults struggle with pre-obesity and obesity, and the prevalence of the disease continues to rise every year. Early identification and education are key to treating patients with an unhealthy weight or elevated BMI. When providers alert patients with a BMI of 25 and “medicalize” a diagnosis, they can change the course of the disease and prevent obesity. Even a 5% to 10% weight loss can make a substantial difference. Partnering with patients to develop a comprehensive treatment plan for weight loss that includes lifestyle changes, behavior motivation and long-term follow-up, we as providers can set patients up for success. What’s more, there are numerous devices and FDA-approved medications that are proven to help treat pre-obesity.

Knowing that patients with a BMI of 25 may be at a higher risk for developing obesity arms providers with important insights to treat even more patients. Of course, more research needs to be done, but detecting pre-obesity earlier allows us to proactively deter the progression to obesity.

Learn more at my session, “Early intervention in weight management: Treating pre-obesity,” at the 2021 Spring Obesity Summit here.

Want to become a member of the Obesity Medicine Association? Join here.

References:

• Fryar CD, et al. Prevalence of overweight, obesity, and severe obesity among adults aged 20 and over: United States, 1960–1962 through 2017–2018. NCHS Health E-Stats. 2020.
• Global BMI Mortality Collaboration. Lancet. 2016;doi:10.1016/S0140-6736(16)30175-1.