2020-10-29 OMA Agenda - Board of Trustees

Treatment for obesity often begins with primary care providers, who are responsible for initiating the conversation around obesity. The initial conversation may involve motivational interviewing techniques and must always be non-judgmental and compassionate, outlining the treatment options available. 29,34 Nutrition counseling is an important piece in the initial treatment phase for obesity, along with physical activity, lifestyle, and behavioral counseling. Anti-obesity medications should be prescribed in a sequential, systematic manner, starting with a single medication. Additional medications might ultimately be prescribed in the same way a provider would prescribe more than one medication for any other chronic disease, as indicated once studies confirm safety and value of this approach. 9 Endoscopic options are available and include intragastric balloon placement and endoscopic sleeve gastroplasty. 35 Bariatric surgery is currently the most efficacious way to achieve and maintain a mean total body weight loss of >20%; laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy are the two most commonly performed bariatric procedures. Primary care providers should also be familiar with the essentials of preoperative preparation and especially post-bariatric surgery follow-up care 36 , as patients may be more likely to follow-up with their primary care provider rather than their bariatric surgery care team. To maintain the continuum of obesity care, there must be collaboration and communication among regional primary care providers, obesity medicine specialists, and bariatric surgeons. Primary care providers and obesity specialists must have a pathway for referral and be knowledgeable about the resources available in their community. The establishment of telemedicine or telehealth options to connect patients with the appropriate obesity specialists should also be explored. The Obesity Action Coalition maintains a repository of healthcare practitioners who treat obesity (https://obesitycareproviders.com/) 37 , and the American College

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