Overview
Taking Aim at Obesity: Strategies for Effective and Equitable Management in Primary Care Practice
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Obesity is a chronic, progressive, and relapsing disease associated with increased risks of cardiovascular disease, type 2 diabetes, dyslipidemia, hypertension, and other serious health complications. In the United States, approximately 40% of adults have obesity and although expert guidelines offer recommendations for optimal management of patients with overweight and obesity, gaps persist. The variables contributing to this are multifactorial, hindering long-term management and leading to undertreatment.
These challenges are further amplified for patients being treated in primary care settings and community health centers that provide care to the most high-risk and underinsured patients in the United States. These providers face increased workloads, financial challenges, and provider burnout, which can further exacerbate inequities in care access.
To support primary care providers in efficiently and effectively improving evidence-based obesity management for all patients, this practice guide synthesizes strategies tested in a real-world setting and frames educational and practical content in an adaptable and sustainable manner so learners can easily model best practices in their own clinical setting.
These challenges are further amplified for patients being treated in primary care settings and community health centers that provide care to the most high-risk and underinsured patients in the United States. These providers face increased workloads, financial challenges, and provider burnout, which can further exacerbate inequities in care access.
To support primary care providers in efficiently and effectively improving evidence-based obesity management for all patients, this practice guide synthesizes strategies tested in a real-world setting and frames educational and practical content in an adaptable and sustainable manner so learners can easily model best practices in their own clinical setting.
This educational activity is designed for US-based primary care providers including community-based providers such as those practicing in ACOs, FQHCs, and rural-based practices.
Obesity is a complex disease associated with increased risks for cardiometabolic complications, including cardiovascular disease, metabolic syndrome, type 2 diabetes, nonalcoholic fatty liver disease, dyslipidemia, and hypertension, among others. In addition, overweight and obesity are associated with a 2.4-year loss-of-life expectancy and nearly 500,000 deaths per year in the United States. Conversely, weight reduction in patients with obesity is associated with decreased complications and improved outcomes. Ideally, obesity would be prioritized for medical management based on the significant risks it poses to patient health. However, obesity has long been stigmatized as a lifestyle issue and has only recently been acknowledged as a chronic disease that requires active clinician management.
Management of obesity is challenging, requiring clinicians to employ a variety of treatment strategies from diet, exercise, and behavior to pharmacologic therapies and surgical procedures; as an additional layer of complexity, clinicians must also apply effective communication skills to best engage patients in discussions about weight. Although diet and exercise remain the foundation of weight management strategies, recent years have seen the introduction of glucagon-like peptide 1 (GLP-1) receptor agonists and dual GLP-1/glucose-dependent insulinotropic polypeptide (GIP) receptor agonists that result in clinically significant weight loss and improvements in outcomes for people with obesity. Unfortunately, many patients who are eligible and would benefit from antiobesity medications have not been receiving them. To ensure that clinicians are knowledgeable and competent in actively treating patients with obesity using evidence-based approaches, it is essential that clinicians receive education regarding the shifting obesity management paradigm.
Upon completion of this activity, learners will be able to:
• Explain the rationale for prioritizing obesity management to improve cardiometabolic outcomes
• Individualize obesity treatment strategies based on latest evidence for weight reduction and cardiometabolic outcomes
• Integrate training and operational frameworks to provide comprehensive, long-term patient care in the primary care setting
• Implement shared decision-making strategies to engage patients and families in discussions around weight management goals, preferences, values, and concerns
• Explain the rationale for prioritizing obesity management to improve cardiometabolic outcomes
• Individualize obesity treatment strategies based on latest evidence for weight reduction and cardiometabolic outcomes
• Integrate training and operational frameworks to provide comprehensive, long-term patient care in the primary care setting
• Implement shared decision-making strategies to engage patients and families in discussions around weight management goals, preferences, values, and concerns
Provided by The University of Chicago Pritzker School of Medicine and the Academy for Continued Healthcare Learning (ACHL).
Supported by an educational grant from Novo Nordisk, Inc.
Scott Kahan, MD, MPH
Director, National Center for Weight and Wellness
Faculty, George Washington University School of Medicine
Washington, DC
Director, National Center for Weight and Wellness
Faculty, George Washington University School of Medicine
Washington, DC
Silvana Pannain, MD
Associate Professor
University of Chicago Medical Center
Director of Chicago Weight
Center for Weight and Metabolic Health
University of Chicago Medicine
Chicago, IL
As a provider accredited by the ACCME, The University of Chicago Pritzker School of Medicine asks everyone in a position to control the content of an education activity to disclose all financial relationships with any ineligible companies. This includes any entity whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients. Financial relationships are relevant if a financial relationship, in any amount, exists between the person in control of content and an ineligible company during the past 24 months, and the content of the education is related to the products of an ineligible company with whom the person has a financial relationship. Mechanisms are in place to identify and mitigate any relevant financial relationships prior to the start of the activity.
Additionally, The University of Chicago Pritzker School of Medicine requires Authors to identify investigational products or off-label uses of products regulated by the US Food and Drug Administration at first mention and where appropriate in the content.
The following financial relationships have been provided:
Scott Kahan, MD, MPH
Consultant: Boehringer Ingelheim, Currax, Lilly, Novo Nordisk
Silvana Pannain, MD
Speaker: Lilly, Novo Nordisk
Research Support: Amgen, Novo Nordisk, Strecture Therapeutics
Stock Ownership (publicly-traded): Lilly, Novo Nordisk
The University of Chicago Pritzker School of Medicine, ACHL staff members and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose.
The content for this activity was developed independently of any ineligible company. All materials are included with permission. The opinions expressed are those of the faculty and are not to be construed as those of the publisher or grantor(s).
This educational activity was planned and produced in accordance with the ACCME Standards for Integrity and Independence in Accredited Continuing Education. Recommendations involving clinical medicine in a continuing medical education (CME/CE) activity must be based on evidence that is accepted within the profession of medicine as adequate justification for their indications and contraindications in the care of patients. All scientific research referred to, reported, or used in CME/CE in support or justification of a patient care recommendation must conform to the generally accepted standards of experimental design, data collection, and analysis.
This CME/CE activity might describe the off-label, investigational, or experimental use of medications and/or devices that may exceed their FDA-approved labeling. Physicians should consult the current manufacturers’ prescribing information for these products. ACHL and The University of Chicago requires the speaker to disclose that a product is not labeled for the use under discussion.
Discussion of scientific information on unapproved uses (SIUU), off-label, investigational, or experimental drug/device use: Phentermine is not approved for long-term weight management. GLP-1 agonists other than liraglutide and semaglutide, pramlintide, SGLT2 inhibitors, zonisamide, metformin, topiramate (as monotherapy), oral semaglutide, orforglipron, cagrisema, survodutide, and retatrutide are not approved for weight management.
This activity will take approximately 90 minutes to complete. To receive credit, learners are required to complete the pretest, view the online activity, and complete the posttest and evaluation. To receive credit, 80% must be achieved on the posttest. A certificate will be immediately available. There is no fee to participate in the activity or for the generation of the certificate.
The University of Chicago Pritzker School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The University of Chicago Pritzker School of Medicine designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physician assistants, nurse practitioners, and nurses may participate in this educational activity and earn a certificate of completion as AAPA, AANP, and ANCC accept AMA PRA Category 1 Credits™ through their reciprocity agreements.
Completion of this activity, including the pretest, posttest, and follow-up assessments, qualifies as a medium weight MIPS improvement activity under MACRA and can be claimed as completion of IA_PSPA 28 of an Accredited Safety or Quality Improvement Program in the Quality Payment Program. Clinicians should submit their improvement activities by attestation via the CMS Quality Payment Program website. You will receive additional information after completing the activity and receiving your certificate via email.
