News and Trends: January 2017

| January 1, 2017

The Obesity Medicine Association (OMA) releases The 2017 Obesity Algorithm
Denver, CO—For millions of Americans battling obesity, the biggest obstacle to weight loss and wellness is not whether they can stick to a diet or exercise regularly, it’s overcoming the bias they encounter at their own doctor’s office.

From blood pressure cuffs and scales designed for adults who do not have obesity, to the lack of resources and limited advice from doctors, patients with obesity often feel abandoned and stigmatized by a medical system that isn’t properly educated about long-term, scientific-based treatment therapies for obesity.

“An overwhelming percentage of my patients report experiencing some form of mistreatment within our current health care system, whether that be outright shaming or dismissal of obesity and related medical problems,” said Jenny Seger, MD, an obesity medicine physician from San Antonio, Texas. “To have obesity in America often makes individuals the target of bullying and mistreatment. I believe it is the last acceptable form of discrimination in this country.”

One of Seger’s patients, Marissa Helm from San Antonio, summed up the frustration many patients feel.

“One of my primary frustrations about my weight loss is that it took so long for a doctor to give me the information and education I needed to make the right choices about my diet and exercise,” she said. “It’s not like I had only been a little overweight for a short period. I had obesity for over a decade, and none of my doctors—general practitioners, OB/GYN, rheumatologist, etc.—ever gave me any information like what Dr. Seger provided.”

Seger is a member of the Obesity Medicine Association, a group of clinicians specially trained in treating obesity using a scientifically proven approach.

The Obesity Medicine Association recently released a tool to better prepare health care providers to treat patients with obesity. The 2017 Obesity Algorithm is the latest version of the association’s resource, published originally in 2013 and updated yearly since then. Key updates in the 2017 version include advice on non-stigmatizing language doctors can use as well as specific guidelines for patient-friendly furniture and office equipment.

“Clinicians and staff should be trained to avoid hurtful comments, jokes, or otherwise being disrespectful, as patients with obesity encounter this type of bias everywhere else,” said Harold Bays, MD, an obesity medicine physician from Louisville, Ky., and a co-author of the Obesity Algorithm.

Bays and his co-authors compiled a list of positive office-space recommendations, such as: providing sturdy‚ armless chairs and extra-large patient gowns. The report advises physician offices be equipped with large adult blood pressure cuffs or thigh cuffs for patients with an upper-arm circumference greater than 34 cm and weight scales with the capacity to measure patients who weigh more than 400 pounds.

“Weight loss is among the most common New Year’s resolutions for patients who are overweight and who want to improve their health,” said Dr. Bays. “To help providers better meet the needs of their patients with obesity, especially when patients make health resolutions, we intended to provide clinicians with a unique resource that is comprehensive in context, scientifically based with substantial updates, and highly focused on the practicalities of clinical obesity management.”

The Obesity Medicine Association believes so strongly in this mission, they make the Obesity Algorithm available for free to any health care professional via download at www.ObesityAlgorithm.org.

Additional updates to the 2017 Obesity Algorithm include the science and function of hormones that control digestion, an expanded section on FDA-approved surgical procedures, an increased focus on nutrients after bariatric surgery, and the importance of bacteria in the digestive system of the patient with obesity. Obesity genetic syndromes are also discussed.

“We have attempted to clarify some of the more sentinel and challenging topics in obesity medicine, including the obesity paradox—where someone can have excess weight or obesity but still be metabolically healthy,” said co-author Craig Primack, MD, an obesity medicine physician from Scottsdale, Ariz. “We also included body composition and energy expenditure assessments, as well as a description of many of the most common diet patterns.”

Visit www.ObesityAlgorithm.org for more information or to download a free copy of the 2017 Obesity Algorithm.

About the Obesity Medicine Association. The Obesity Medicine Association (OMA) is the largest organization of clinicians dedicated to preventing, treating, and reversing the disease of obesity. Members of OMA believe treating obesity requires a scientific and individualized approach comprised of nutrition, physical activity, behavior, and medication. When personalized, this comprehensive approach helps patients achieve their weight and health goals. Visit www.obesitymedicine.org to learn more.

News from American Association of Clinical Endocrinologists

2017 Update for Type 2 Diabetes Comprehensive Management Algorithm Published By American Association of Clinical Endocrinologists, American College of Endocrinology
JACKSONVILLE, Florida (BUSINESS WIRE)—The American Association of Clinical Endocrinologists (AACE) and the American College of Endocrinology (ACE) announced the publication of an update to its Comprehensive Type 2 Diabetes Management Algorithm.

Designed to serve as a practical and easy-to-use decision-making tool for patients’ medical management, the 2017 algorithm emphasizes obesity as one of the underlying risk factors for type 2 diabetes (T2D) and its microvascular complications, reiterating the organizations’ recently published position that obesity is fundamentally a chronic, complications-centric, progressive disease requiring long-term commitment to weight loss and maintenance lifestyle therapies.

Specifically, it states that weight loss therapy consisting of a lifestyle prescription that incorporates a reduced-calorie healthy meal plan, prescribed physical activity and behavioral intervention should be considered in all patients with prediabetes and T2D who also are diagnosed as overweight or obese. Further, it recommends consideration of weight loss medications approved for the chronic management of obesity if necessary to achieve the degree of weight loss required to reach prediabetes or T2D therapeutic goals.

The algorithm also focuses on stratified cardiovascular risk factors and treatment recommendations based on a patient’s risk profile, as well as detailed assessment of all FDA-approved antidiabetic medications and their impact on congestive heart failure and atherosclerotic cardiovascular disease.

“Incorporating an emphasis on obesity and the role it plays in the development and management of type 2 diabetes, and necessary weight loss therapies into our algorithm update, as well as details regarding the evaluation and treatment of cardiovascular risks, should provide helpful guidance to physicians in providing optimal care to their patients,” said Algorithm Task Force Chair Alan J. Garber, MD, PhD, FACE.

“Both the guidelines and algorithm, while detailed, are constructed to address specific problems in diabetes care in a concise, practical and actionable manner that will assist clinical caregivers with developing patient care plans,” he added.

The Comprehensive Diabetes Management Algorithm 2017 Update is published online at https://www.aace.com/publications/algorithm and is scheduled for publication in the February 2017 issue (Volume 23, Issue 2) of the association’s monthly peer-reviewed scientific journal Endocrine Practice.

About the American Association of Clinical Endocrinologists (AACE). The American Association of Clinical Endocrinologists (AACE) represents more than 7,000 endocrinologists in the United States and abroad. AACE is the largest association of clinical endocrinologists in the world. The majority of AACE members are certified in endocrinology, diabetes and metabolism and concentrate on the treatment of patients with endocrine and metabolic disorders including diabetes, thyroid disorders, osteoporosis, growth hormone deficiency, cholesterol disorders, hypertension and obesity. Visit our site at http://www.aace.com.

About the American College of Endocrinology (ACE). The American College of Endocrinology (ACE) is the charitable, educational and scientific arm of the American Association of Clinical Endocrinologists (AACE). ACE is the leader in advancing the care and prevention of endocrine and metabolic disorders by: providing professional education and reliable public health information; recognizing excellence in education, research and service; promoting clinical research and defining the future of Clinical Endocrinology. For more information, please visit http://www.aace.com/college/.

About the Journal. Endocrine Practice, the official journal of the American College of Endocrinology (ACE) and the American Association of Clinical Endocrinologists (AACE), is a peer-reviewed journal published twelve times a year. The Journal publishes the latest information in the treatment of diabetes, thyroid disease, obesity, growth hormone deficiency, sexual dysfunction and osteoporosis, and contains original articles, case reports, review articles, commentaries, editorials, visual vignettes, as well as classified and display advertising. Special issues of Endocrine Practice also include AACE clinical practice guidelines and other AACE/ACE white papers. Complete content is available on the Endocrine Practice website at http://journals.aace.com.

What’s the biggest hurdle when treating the disease of obesity? It starts with the name. It’s time to redefine obesity, say leading experts.
JACKSONVILLE, Florida—As a means to revolutionize the diagnosis, treatment and management of one of the world’s most menacing chronic diseases—obesity, the American Association of Clinical Endocrinologists (AACE) and the American College of Endocrinology (ACE) released a bold statement that redefines the medical diagnostic term of obesity—a disease with which more than one-third (36.5 percent) of U.S. adults have been diagnosed, according to the Centers for Disease Control and Prevention (CDC).

The new term developed and introduced by AACE and ACE—Adiposity-Based Chronic Disease or ABCD—focuses on the characteristic pathophysiological effects of excess weight, rather than the weight itself, and offers physicians standardized protocols for weight loss and treatments for obesity-related conditions such as type 2 diabetes, heart disease, stroke, some types of cancers and others.

For many years, obesity has been overwhelmingly defined and measured using Body Mass Index (BMI), a calculation involving only a subject’s weight and height, not taking other factors such as muscle mass into account. This imprecise and confusing term also fails to address the health implications of excess weight. Further, the term “obesity” carries with it a societal stigma that negatively effects treatment and care opportunities. By redefining the term to address the negative health outcomes from obesity, improvements in screening and patient clinical care should improve dramatically.

In 2012, AACE first declared obesity as a disease state, an assessment officially adopted by the American Medical Association in 2014.

The new ABCD diagnostic term will be incorporated into the AACE/ACE chronic care model available to all health professionals, and is a direct outgrowth of the AACE/ACE 2014 Consensus Conference on Obesity, in which leading international experts collaborated on the need for a medically meaning and actionable diagnosis of obesity.

Visit http://journals.aace.com/doi/pdf/10.4158/EP161688.PS?code=aace-site to view the the ABCD position statement on obesity.

Category: News and Trends, Past Articles

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