Driving Action and Progress on Obesity Prevention and Treatment Proceedings of a Workshop (2017) / Chapter Skim
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6 Treatment Challenges
6 Treatment Challenges
Pages 47-54
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From page 47... ...
David Fukuzawa, managing director for health and human services at The Kresge Foundation, observed that, just as obesity is a complicated disease to prevent, it is a complicated disease to treat. Obesity may consist of a complex combination of different diseases, with treatment, especially for severe obesity, requiring more than better nutrition and physical activity, he noted.
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From page 48... ...
. New drug treatments can produce weight losses of 5 to 10 percent, she noted, which might translate to 25 pounds in a patient with a body mass index (BMI)
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From page 49... ...
; Imaz et al., 2008 (intragastric balloon) ; Kashyap et al., 2010 (bariatric surgery: gastric banding, gastric bypass, gastric sleeve gastroectomy)
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From page 50... ...
With gastric bypass surgery, sleeve gastrectomy, and medications, for example, African Americans tend to lose less weight than non-Hispanic whites in clinical trials, probably because of a complicated interplay of physiological drivers, access to care, and treatment responses (Lewis et al., 2016)
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From page 51... ...
adults have severe obesity, Fukuzawa noted, meaning that, at current levels of board-certified physicians, each trained obesity specialist would have to serve approximately 11,000 patients. Even if the pool of physicians able to treat obesity were considered to be all primary care physicians, he said, including family practitioners and general practice, internal medicine, and obstetrics/gynecology physicians, each physician would need to treat about 90 people with severe obesity (a BMI greater than 40)
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From page 52... ...
The challenge, Fukuzawa said, is to connect these components through various mechanisms to achieve the greatest possible effect. Building on this point, Bradley observed that only 10 percent of premature deaths related to the social determinants of health can be accounted for by influences from health care (Schroeder, 2007)
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From page 53... ...
An interesting question, for example, is how the YMCA's Diabetes Prevention Program could be scaled up and used in a multidisciplinary program. "We're never going to have enough obesity medicine specialists, certainly in the next 20 years," Apovian argued, "to start pushing back on this problem.
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