Why PCPs Find It Challenging to Help Patients Lose Weight

Why PCPs Find It Challenging to Help Patients Lose Weight As providers of medical transcription outsourcing services to primary care physicians, we know how important the role of a PCP is in the community It is necessary for PCPs to start implementing new and innovative approaches to treat obesity.

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Obesity and weight loss are terms that appear in bariatric/weight loss medical transcription reports that a medical transcription outsourcing company prepares for weight loss physicians and bariatric surgeons. Morbidly obese patients are often referred to bariatric surgeons or weight loss physicians for treatment of obesity. Obese patients try many weight loss attempts that are usually supervised by a physician or dietician. These attempts are made in the hope of reducing or eliminating comorbid conditions such as sleep apnea, Type 2 diabetes, hypertension and heart problems, and living a longer, healthier life. But can a doctor really help an obese patient lose weight? In the US, the problem of obesity is rising steadily thereby increasing the risk of diabetes, heart attack, cancer and other health issues. According to a report from the Centre for Diseases Control and Prevention, around 40 percent of American adults are obese and over 57 percent of children are obese by the time they reach the age of 35.

It has been suggested that primary care physicians may be the best persons to provide the right counselling to their obese patients and help them lose weight. The United States Preventive Service Task Force, an independent panel of experts has also reinforced the physician’s role in engaging patients in weight loss efforts by recommending that physicians should screen “all adults for obesity and offer or refer patients with a BMI of 30 kg/m2 to intensive, multi-component behavioural interventions.”

However, PCPs have not been very successful in this regard. According to a study (regarding primary care physician (PCP) weight-related counselling, comparing counselling rates in 1995–1996 and 2007–2008) by Dr. Jennifer Kraschnewski, an Associate Professor at the Pennsylvania State University, •

Only 6 percent of visits include counselling for weight loss.

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The rates of counselling for diet and exercise have decreased with greater decline in health seen in patients with diabetes, hypertension and obesity who would have benefited from healthy lifestyle changes.

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A small minority (9 percent) of PCPs are performing the majority, i.e. 52 percent, of all reported weight counselling.

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The majority PCPs (58 percent), failed to perform any weight counselling during patients visits across the study years.

The main reasons why PCPs are not engaging much in weight loss counseling is because •

PCPs are pessimistic about how much the patient can change

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Physicians have time limitations

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Physician’s training and skills for counseling are inadequate

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Sometimes physicians are not reimbursed for spending time on counseling

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PCPs often don’t have time for counseling due to rising number of other clinical items.

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Few tools exist that can help PCPs counsel patients.

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Weight loss programs in a primary care setting are relatively ineffective

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There are only a handful of prescription medications available to PCPs to prescribe, with several medications withdrawn from the market following safety concerns.

In 2012, the Centres for Medicare and Medicaid implemented coverage for intensive behavioural therapy for obesity by PCP and the Patient Protection and Affordable Care Act expanded this coverage to all adults by requiring health insurance carriers cover this and other recommendation.

However, this doesn’t guarantee any success. Although the new reimbursement structure provides a payment for visit frequency, it is still not clear as to how to implement counselling in a primary care set up. Another study by Dr. Jennifer Kraschnewski and her colleague found that patients who were obese were more likely to report successfully losing 5 percent of their body weight if in the past year their doctor had simply told them they were overweight.

Although obesity is recognized as a chronic disease, it is still not treated so in a clinical setting. It is therefore important for PCPs to start thinking about implementing new and innovative approaches to treat obesity. As providers of medical transcription outsourcing services to primary care physicians, we know how important the role of a PCP is in the community. Patients share a close relationship with them, and therefore they are the best people to counsel their patients on the importance of a healthful diet, the need to lose weight, and make the lifestyle changes necessary to maintain an ideal weight.

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