Weight loss: Docs need better education on obesity, goals for patients

By Aine Cryts

Patients' unwillingness to follow a weight-loss plan is the most challenging part of treating obese patients, say 36 percent of healthcare providers.That's according to a recent survey published in Medscape of close to 1,500 clinicians, including both primary care providers and specialists.

Providers also cite other challenges to treating obese patients:

  • lack of effective treatment options (24 percent)
  • inadequate reimbursement for treating obesity (16 percent)
  • patient education about the health effects of obesity (9 percent)
  • need for more doctors to recognize and treat the disease (7 percent)
  • availability of improved guidelines on whom and how to treat the disease (6 percent)

It's not simply that patients are unwilling to adhere to a lifestyle plan, Donna H. Ryan, M.D., professor emerita at Louisiana State University's Pennington Biomedical Research Center in Baton Rouge, told Medscape in an article about the survey. Healthcare professionals must be taught in medical school and nursing school about treating obesity, according to Ryan.

"Providers who think that the patient's obesity is merely the result of a series of personal choices, that appetite can be controlled by willpower alone, that we only need educate patients and prescribe a healthy diet and physical-activity pattern, that patients who are struggling only need to try with more resolve--well, those providers are doomed to frustration," she told the publication.

Here are two pieces of advice on treating patients with obesity, from the experts cited in the article:

Coach patients to be realistic about their goals and encourage them to adhere to care plans. Most patients aren't going to lose more than 10 percent of their weight, George Bray, M.D., professor emeritus at the Pennington Biomedical Research Center, told Medscape. Even those patients who lose weight successfully will often hit a "plateau" in their weight loss. As a result, they may stop taking medications that were prescribed as part of their treatment plan. And then they regain the weight, according to Bray.

Have the right goal in mind. It's not the patient's weight that determines success--rather, it's their ability to achieve improvements on their targeted weight loss, Ryan told the news site. It's realistic for patients to achieve anywhere between 5 percent to 15 percent weight loss, according to Ryan.

While many haven't been trained to treat their patients who struggle with obesity, Ryan told Medscape that she's encouraged that more providers are now learning these skills that help patients achieve long-term success.

To learn more:
- read the survey
- check out the article