Virtual Primary Care for the Treatment of Obesity

January 18, 2022

Dr. Eric Bricker

What is obesity? 

Obesity is a serious health condition. Virtual primary care can be an effective tool for weight management. 

38% of Americans are obese with a BMI of 30-40 kg/m2. For context, a person who is 5 feet, 4 inches tall and weighs 205 pounds has a BMI of 35. Additionally, 8% of Americans are severely obese with a BMI > 40 kg/m2. A person who is 5 feet, 10 inches tall and weighs 315 pounds has a BMI of 45. 

Obesity is associated with 195 co-morbid medical conditions, many becoming more common as the severity of obesity increases. For example, men with a BMI of >40 have 19 times greater prevalence of diabetes than men in a healthy weight range. Women with a BMI >40 have 13 times greater prevalence of diabetes. 

How can you treat obesity? 

Losing weight directly improves health outcomes. A review by researchers from the Mayo Clinic found that “maintaining weight loss of 5% to 10% for 1 or more years is associated with improvements in major risk factors.” 

Along with a healthy and clinically monitored routine of diet and exercise, counseling is a successful way to promote weight loss. This same Mayo Clinic review also found that “patients receiving behavioral counseling lost more than 8% of body weight during the first year and, at year 8, 50% of patients maintained a 5% or more loss.” 

How can virtual primary care treat obesity? 

Virtual primary care provides an excellent means of counseling patients on weight loss by providing a routine and comfortable way for patients to engage with their doctors. 

Sometimes patients who are obese do not seek medical care because of the in-person office setting. The Mayo Clinic review states, “Many people with obesity feel stigmatized and unwelcome in the clinic [because] waiting room furniture, weighing scales or examination tables are of insufficient capacity for heavier patients.” Virtual primary care overcomes this barrier by allowing patients with obesity to receive care in a more comfortable setting of their choosing. 

Doctors themselves often do not properly counsel patients who are obese and need to lose weight. Physician barriers include limited time, shortage of resources and inadequate reimbursement. Historic fee-for-service payment encourages doctors to see patients as quickly as possible, contributing to these barriers.  

Alternatively, virtual primary care is key to removing these barriers. Offered as part of employer-sponsored benefits packages, virtual primary care provides unlimited visits for patients, often at $0 out of pocket cost. Virtual primary care practices arranged in this way are financially aligned to spend the time necessary to counsel obese patients on weight loss. 

Another barrier to effective weight-loss counseling is the frequent visits necessary to achieve results. Guidelines recommend that initial counseling should be weekly or biweekly, followed by monthly counseling sessions for 6 months, followed by less frequent long-term maintenance counseling. Asking a patient with obesity to come to a doctor’s office frequently is unrealistic. 

However, virtual primary care allows for the convenience necessary to accomplish such frequent visits since it eliminates travel time, travel expense, the need to arrange for childcare, the need to take off from work and time wasted in an office waiting room. 

In summary, virtual primary care conveniently and effectively facilities weight-loss counseling for patients with obesity. Virtual primary care is also advantageous for doctors, giving them the opportunity to provide counseling. It’s practical, removing the everyday logistical barriers of receiving care. 

Sources: https://www.mayoclinicproceedings.org/article/S0025-6196(18)30033-8/fulltexthttps://jamanetwork.com/journals/jama/article-abstract/192030 

 

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Originally published Jan 18, 2022 3:00:00 PM.