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    Four ways providers can use coaching to treat obese patients


    The CDC reports that 38% of American adults over age 20 years are obese, which the CDC defines as adults with a body mass index (BMI) of 30 or higher. As most pediatricians across the country already know, children also struggle with obesity. In fact, 21% of adolescents are considered obese, as are 18% of children between the ages of 6 and 11 and 8% of children between the ages of 2 and 5.

    ApovianApovianIt's incredibly difficult to lose weight and then sustain that weight loss, says Sharon Movsas, a registered dietitian and coordinator of the Diabetes Education Program at Montefiore Medical Center in Bronx, New York.

    There’s no “magic bullet,” agrees Caroline Apovian, MD, director of the Nutrition and Weight Management Center at Boston Medical Center.

    While there are many interventions for treating obesity, the hard reality is success requires dramatic behavioral and lifestyle changes—and that’s why it’s so important for physicians, advanced practitioners, and nurses to engage in patient coaching.

    Here are four tips for coaching obese patients:

    1. Understand the life experiences of patients who are struggling with obesity. Many of the obese patients Apovian treats have significant financial challenges—and that can restrict access to healthy foods. “They can’t afford to go out to Whole Foods and buy expensive fruits and vegetables,” she says. Instead, they typically eat fast-food.

    Primary care doctors can become more aware of these issues, and provide information about support services, by leveraging the “Five As,” says Apovian. The Five As stand for:

    • Ask

    • Advise

    • Assess

    • Assist

    • Arrange

    Providers should also keep in mind that CMS now covers multiple visits for weight management, and that patients can be seen monthly or even more often at the beginning of their weight-loss journey, says Apovian.

    Next: Coaching tip #2


    Aine Cryts
    Aine Cryts is a freelancer based in Boston. She is a frequent contributor to Managed Healthcare Executive on topics such as diabetes, ...


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