A survey of over 3000 primary care providers attending CME programs in weight management stated that they use BMI to discuss weight loss with patients only 41% of the time. The most frequently cited reasons are not enough time in a visit and belief that patients cannot make the lifestyle changes necessary to lose weight. Public health recommendations are for individuals with BMI above 25 to lose 5-10% of body weight. This amount of weight loss improves many metabolic health risk factors such as blood pressure, blood glucose, triglycerides and HDL cholesterol and reduces incidence of diabetes, cancer, cardiovascular events, and overall mortality.
Several studies illustrate that group weight loss programs using behavioral nutrition therapy and conducted for 6-12 months in a PCP office setting can produce significant weight loss of 5-10%. Providers can find a dietitian to partner with and lead such groups at eatright.org/find-an-expert.
But losing weight and keeping it off is the real goal since regaining lost weight means losing the clinical benefits. A new study published in the September issue of Obesity Journal (link) supports that primary care providers can help patients keep their weight off with ongoing behavioral nutrition counseling.
Behavioral nutrition counseling allowed 26.7% of patients with overweight or obesity to lose at least 10% of their body weight and maintain the loss for more than a year. Predictors of success were
- more frequent contact with the PCP and
- initial weight loss at 1 month. The faster someone loses weight-ie significant loss at 2-4 weeks, the more likely they are to be successful at keeping it off at 1 year.
Providing behavioral nutrition therapy in the office setting with frequent patient contact can help patients and providers be successful in improving health outcomes.