Skip to main content
SpringerLink
Log in

Optimizing Outcomes in Outpatient Obesity Management

  • Chapter
  • First Online:
Quality in Obesity Treatment

  • 563 Accesses

Abstract

Obesity is a complicated disease that requires a comprehensive, longitudinal approach to effectively manage it. Just as other chronic diseases such as heart disease or cancer require varying levels of care depending on where the patient may be in the disease process, obesity is no different. Generally speaking, as complex and sophisticated as our current healthcare system is, we are failing miserably when it comes to the prevention and treatment of obesity. Our system is not currently set up to provide care for obesity at varying intensity levels, nor is it clear whose responsibility it is to provide this care. In the optimal setting, all providers would receive thorough training as it relates to the pathophysiology, and the prevention and treatment of obesity and care would be provided to all patients who desire treatment. A disease as complicated and detrimental to patients and our economy as obesity should not be allowed to be listed as an exclusion in healthcare policies, which is currently the norm rather than the exception. Obesity is a public health crisis of epidemic proportions that requires a global, comprehensive all hands-on deck approach to prevention and treatment. This chapter will explore the outpatient management of obesity and what comprehensive care entails. In this chapter we will use the feminine pronoun for simplicity, understanding that it pertains to all gender identities.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Puhl RM, Brownell KD. Bias, discrimination, and obesity. Obes Res. 2001;9:788–905.

    Article  CAS  Google Scholar 

  2. Puhl RM, Heuer CA. The stigma of obesity: a review and update. Obesity. 2009;17:941–64.

    Article  Google Scholar 

  3. Vitolins MZ, Crandall S, Miller D, Ip E, Marion G, Spangler JG. Obesity educational interventions in U.S. medical schools: a systematic review and identified gaps. Teach Learn Med. 2012;24(3):267–72.

    Article  Google Scholar 

  4. Association of American Medical Colleges. Report VIII contemporary issues in medicine: the prevention and treatment of overweight and obesity. 2007.

    Google Scholar 

  5. Phelan SM, et al. Impact of weight bias and stigma on quality of care and outcomes for patients with obesity. Obes Rev. 2015;16:319–26.

    Article  CAS  Google Scholar 

  6. Foster GD, Wadden TA, Makris AP, Davidson D, Sanderson SS, et al. Primary care physicians’ attitudes about obesity and its treatment. Obes Res. 2003;11(10):1168–77.

    Article  Google Scholar 

  7. Bays HE, Seger JC, Primack C, McCarthy W, Long J, Schmidt SL, Daniel S, Wendt J, Horn DB, Westman EC. Obesity algorithm, presented by the Obesity Medicine Association. www.obesityalgorithm.org. 2016–2017.

  8. Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation. 2013;63:39.

    Google Scholar 

  9. AACE/ACE Obesity CPG, Endocr Pract. 2016;22(Suppl 3).

    Google Scholar 

  10. Obesity Action Coalition. http://www.obesityaction.org/weight-bias-and-stigma/people-first-language-for-obesity. Accessed 7 May 2018.

  11. Strategies to Overcome and Prevent Obesity Alliance. http://stopobesityalliance.org/wp-content/themes/stopobesityalliance/pdfs/STOP-Provider-Discussion-Tool.pdf. Accessed 7 May 2018.

  12. Medical Care for Obese Patients. United States Department of Health and Human Services. 2007. United States Department of Health and Human Services, National Institutes of Diabetes and Digestive and Kidney Diseases. http://www.win.niddk.

  13. Thomas SA, Lee-Fong M. Maintaining dignity of patients with morbid obesity in the hospital setting. Bariatric Times. 2010;8(4):20–5.

    Google Scholar 

  14. Sackner-Bernstein J, Kanter D, Kaul S. Dietary intervention for overweight and obese adults: comparison of low-carbohydrate and low-fat diets. A meta-analysis. PLoS One. 2015;10(10):e0139817.

    Article  Google Scholar 

  15. Foster G, Wyatt H, Hill J, Makris A, Rosenbaum D, Brill C, et al. Weight and metabolic outcomes after 2 years on a low-carbohydrate versus low-fat diet a randomized trial. Ann Intern Med. 2010;153:147–57.

    Article  Google Scholar 

  16. Shai I, Schwarzfuchs D, Henkin Y, Shahar D, Witkow S, Greenberg I, et al. Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. N Engl J Med. 2008;359:229–41.

    Article  CAS  Google Scholar 

  17. Santos F, Esteves S, Costa Pereira A, Yancy W Jr, Nunes J. Systematic review and meta-analysis of clinical trials of the effects of low carbohydrate diets on cardiovascular risk factors. Obes Rev. 2012;13:1048–66.

    Article  CAS  Google Scholar 

  18. Hession M, Rolland C, Kulkarni U, Wise A, Broom J. Systematic review of randomized controlled trials of low-carbohydrate vs. low-fat/low-calorie diets in the management of obesity and its comorbidities. Obes Rev. 2009;10:36–50.

    Article  CAS  Google Scholar 

  19. Tobias DK, et al. Effect of low-fat diet interventions versus other diet interventions on long-term weight change in adults: a systematic review and meta-analysis. Lancet Diabetes Endocrinol. 3(12):968–79.

    Google Scholar 

  20. Mulholland Y, Nicokavoura E, Broom J, Rolland C. Very-low-energy diets and morbidity: a systematic review of longer-term evidence. Br J Nutr. 2012;108:832–51.

    Article  CAS  Google Scholar 

  21. Parretti HM, Jebb SA, Johns DJ, Lewis AL, Christian-Brown AM, Aveyard P. Clinical effectiveness of very-low-energy diets in the management of weight loss: a systematic review and meta-analysis of randomized controlled trials. Obes Rev. 2016;17:225–34.

    Article  CAS  Google Scholar 

  22. Physical activity appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Medicine and Science in Sports and Exercise. American College of Sports Medicine DOI:https://doi.org/10.1249/MSS.0b013e3181949333.

  23. Strasser B. Physical activity in obesity and metabolic syndrome. Ann N Y Acad Sci. 2013;1281:141–59.

    Article  Google Scholar 

  24. Garland T Jr, Schutz H, Chappell MA, Keeney BK, Meek TH, Copes LE, et al. The biological control of voluntary exercise, spontaneous physical activity and daily energy expenditure in relation to obesity: human and rodent perspectives. J Exp Biol. 2011;214:206–29.

    Article  Google Scholar 

  25. Hamilton MT, Hamilton DG, Zderic TW. Role of low energy expenditure and sitting in obesity, metabolic syndrome, type 2 diabetes, and cardiovascular disease. Diabetes. 2007;56(11):2655–67.

    Article  CAS  Google Scholar 

  26. Healy GN, Matthews CE, Dunstan DW, Winkler EA, Owen N. Sedentary time and cardio-metabolic biomarkers in US adults: NHANES 2003–06. Eur Heart J. 2011;32(5):590–7.

    Article  Google Scholar 

  27. Wadden TA, West DS, Neiberg RH, Wing RR, Ryan DH, Johnson KC, Foreyt JP, Hill JO, Trence DL, Vitolins MZ, Look AHEAD Research Group. One-year weight losses in the Look AHEAD study: factors associated with success. Obesity (Silver Spring). 2009 Apr;17(4):713–22.

    Article  Google Scholar 

  28. Van Dorsten B, Lindley EM: Cognitive and behavioral approaches in the treatment of obesity. Med Clin North Am. 2011.

    Google Scholar 

  29. Elwyn G, Dehlendorf C, Epstein RM, Marrin K, White J, Frosch DL. Shared decision making and motivational interviewing: achieving patient-centered care across the spectrum of health care problems. Ann Fam Med. 2014;12:270–5.

    Article  Google Scholar 

  30. Puzziferri N, Roshek T III, Helen G, Mayo HG, Gallagher R, Belle SH, Living-ston EH. Long-term follow-up after bariatric surgery: a systematic review. JAMA. 2014;312(9):934–42.

    Article  CAS  Google Scholar 

  31. Thereaux J, Lesuffleur T, Païta M, Czernichow S, Basdevant A, Msika S, et al. Long-term follow-up after bariatric surgery in a national cohort. BJS. 2017;104:1362–71.

    Article  CAS  Google Scholar 

  32. Thomas JG, Bond DS, Phelan S, Hill JO, Wing RR. Weight-loss maintenance for 10 years in the National Weight Control Registry. Am J Prev Med., 2014. 2014;46(1):17–23.

    Article  Google Scholar 

  33. Middleton KM, Patidar SM, Perri MG. The impact of extended care on the long-term maintenance of weight loss: a systematic review and meta-analysis. Obes Rev. 2012;13:509–17.

    Article  Google Scholar 

  34. The American Board of Obesity Medicine. Statistics and data. http://www.abom.org/stats-data. Accessed 30 July 2019.

    Google Scholar 

  35. Prochaska J, DiClemente C, Norcross J. In search of how people change: applications to addictive behaviors. Am Psychol. 1992;47(9):1102–14.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Bariatric Medical Institute of Texas, San Antonio, TX, USA

    Jennifer C. Seger

Authors
  1. Jennifer C. Seger
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Surgery, Yale New Haven Hospital, New Haven, CT, USA

    John M. Morton

  2. Department of Surgery, The Ohio State University, Columbus, OH, USA

    Stacy A. Brethauer

  3. Vidant Medical Center, East Carolina University, Greenville, NC, USA

    Eric J. DeMaria

  4. Johns Hopkins Bloomberg School of Public, National Center for Weight and Wellness, Washington, DC, USA

    Scott Kahan

  5. Massachusetts General Hospital, Boston, MA, USA

    Matthew M. Hutter

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Seger, J.C. (2019). Optimizing Outcomes in Outpatient Obesity Management. In: Morton, J., Brethauer, S., DeMaria, E., Kahan, S., Hutter, M. (eds) Quality in Obesity Treatment. Springer, Cham. https://doi.org/10.1007/978-3-030-25173-4_23

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-25173-4_23

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-25172-7

  • Online ISBN: 978-3-030-25173-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation