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10mo
Redefining Patient Identification for Obesity Management

Obesity is a multifaceted chronic disease influenced by genetic, biological, behavioral, and environmental factors. Yet, it remains one of the most stigmatized and undertreated conditions. Studies reveal that counseling rates for obesity are low among healthcare providers, often due to time constraints, lack of training, and fear of offending patients. These barriers, coupled with the physiological adaptations that resist weight loss, highlight the importance of recognizing obesity as a medical condition requiring comprehensive management strategies.

The Edmonton Obesity Staging System offers a valuable framework for risk stratification, emphasizing a patient-centered approach that goes beyond BMI. Incorporating obesity-focused histories and motivational interviewing can guide tailored interventions that improve quality of life and reduce obesity-related comorbidities.

As healthcare professionals, how can we redefine patient identification to ensure early, respectful, and effective obesity care? What tools or strategies have you found helpful in expanding the scope of patients considered appropriate for treatment?

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  • 10mo
    Look not only at BMI but also at Family and Habits risk factors as well as lifestyle and waist circumference
  • 11mo
    obesity has a multifactorial side effects from mental health to physical complaints with diseases from obesity.
  • 11mo
    Each pt should get weight and BMI checked at each visit. I proactively discuss weight loss meds with each pt and provide them with hand out if they are not ready to start the medication at the same visit.
  • 11mo
    Using measures beyond weight and BMI are important such as weight circumference, fat percentage, cardiac risk markers, insulin resistance and related comorbidities. Making it a regular part of a discussion of health risks and removing any and all terminology that assigns blame or fault to the individual.
  • 11mo
    Most important is lifestyle change, without that it is very difficult to succeed with medications alone, We need to incentivize patients more to watch their diet, join a gym and do the right things
  • 11mo
    Expanding obesity care requires moving beyond BMI to a more holistic, patient-centered approach. The Edmonton Obesity Staging System (EOSS) helps assess health risks beyond weight alone. Key strategies include:
    • Obesity-Focused Histories: Assess weight-related complications and past treatment attempts.
    • Motivational Interviewing: Focus on health improvements rather than just weight loss.
    • Broader Identification Criteria: Consider metabolic risk and weight regain, not just BMI.
    • Technology & Digital Tools: Use body composition analysis and EHR decision support.
    • Interdisciplinary Collaboration: Involve dietitians, psychologists, and specialists early.

    These strategies help ensure respectful, effective, and early obesity care.
  • 11mo
    CGMS and AIDs can be seamlessly integrated into clinical practice if the insurance companies lower the barriers/restrictions and the cost to patients and physicians. SGLT2, a critical class of meds are also under the control of the insurance companies instead of HCPs. Penny wise, pound foolish...
  • 11mo
    I have not used the Edmonton Obesity Staging System. Seems like something that maybe helpful. Many times it is patients that are initiating discussion about weight loss medication and what they heard and saw in news. I review BMI, co-morbidities, current and past medications, genetics, prior attempts and what programs were used.
  • 11mo
    Edmonton Obesity Staging System helps to identify patients who may benefit from obesity intervention. This system does also expand the scope of patients who need treatment by checking for comorbid conditions through history (depression, eating disorders), lab work (IFG, HLD), vital signs (HTN), imaging for OA, sleep studies (OSA), etc.
  • 11mo
    Structured weight management programs have been the most successful with weekly or biweekly followup up to 3-4 months then monthly. This gives a referral spot for providers to refer to skilled professionals that meet those goals of success and respectivefulness.
  • 11mo
    All of these recommendations are excellent, time is a factor though for appointments. Now that we have more effective treatments with GLP-1s, it seems easier to talk about obesity with patient and they seem to free to inquire about it more.
  • 11mo
    i only use BMI if needing to prescribe GLP 1 or get referrals approved for nutrition or metabolic clinic. Otherwise, my approach to the patient is that BMI is a risk factor for cardiovascular risk and the steps to lower BMI help to reduce risk of cardio related illness/disease.
    i like to meet patients where they are and ask if we can discuss their weight or if there are any trigger words that they would like me to avoid using. many patients have traumatic childhood experiences surrounding their weight or relationship with food.
  • 11mo
    Bmi, genetics, family diet habits
  • 11mo
    U have to look at BMI, family diet habits, generic factors
  • 11mo
    Proper identification should include not only just BMI, but they’re genetic disposition, family history and other medical comorbidities as well as their mental and social aspects that may affect their behavior or tendency for obesity.
  • 11mo
    With all the concerns about coverage for obesity and lack of supplies, lack of payment from insurance companies it is important to tease out the patients that are in most need of the medication. Have them get on, stay on and maintain the medication for the best results although truth be told patients on long-standing medication due seem to reach a plateau and weight loss which does seem to subsequently end up with continued weight Gain thereafter, if not significant behavioral modification is followed
  • 11mo
    While BMI certainly helps categorize obesity, I think that the Edmonton Obesity Staging System is helpful in stratifying risk for obesity. Because certainly obesity goes beyond just the BMI. It incorporates co-morbid conditions, physical limitations and symptoms as well as psychological symptoms in helping us clinicians target patients who will need intervention
  • 11mo
    It is important to identify patients who have obesity by BMI, but also buy body habits type family, history of obesity, morbid obesity, prediabetes family, history of diabetes, which might pour 10 greater likelihood to developing type two diabetes and patient may respond better to GLP one
  • 11mo
    Instead of using BMI alone, which is outdated (in my opinion) other measurements such as waist circumference, body fat percentage, and other biomarkers (ex metabolic health indicators [labs]) can help identify individuals who may not fall under the traditional BMI definition of obesity but still face health risks associated with excess body fat.
    Also Integrating obesity screening into annual checkups or wellness visits to catch weight-related health risks early. Catching early signs of obesity can lead to more effective preventive interventions. Non-invasive, patient-centered strategies such as counseling on diet and exercise before moving to more aggressive treatments. This can help in preventing the progression of obesity-related conditions.
  • 11mo
    Instead of using BMI alone, which is outdated (in my opinion) other measurements such as waist circumference, body fat percentage, and other biomarkers (ex metabolic health indicators [labs]) can help identify individuals who may not fall under the traditional BMI definition of obesity but still face health risks associated with excess body fat.
    Also Integrating obesity screening into annual checkups or wellness visits to catch weight-related health risks early. Catching early signs of obesity can lead to more effective preventive interventions. Non-invasive, patient-centered strategies such as counseling on diet and exercise before moving to more aggressive treatments. This can help in preventing the progression of obesity-related conditions.
  • 11mo
    Instead of using BMI alone, which is outdated (in my opinion) other measurements such as waist circumference, body fat percentage, and other biomarkers (ex metabolic health indicators [labs]) can help identify individuals who may not fall under the traditional BMI definition of obesity but still face health risks associated with excess body fat.
    Also Integrating obesity screening into annual checkups or wellness visits to catch weight-related health risks early. Catching early signs of obesity can lead to more effective preventive interventions. Non-invasive, patient-centered strategies such as counseling on diet and exercise before moving to more aggressive treatments. This can help in preventing the progression of obesity-related conditions.
  • 11mo
    Instead of using BMI alone, which is outdated (in my opinion) other measurements such as waist circumference, body fat percentage, and other biomarkers (ex metabolic health indicators [labs]) can help identify individuals who may not fall under the traditional BMI definition of obesity but still face health risks associated with excess body fat.
    Also Integrating obesity screening into annual checkups or wellness visits to catch weight-related health risks early. Catching early signs of obesity can lead to more effective preventive interventions. Non-invasive, patient-centered strategies such as counseling on diet and exercise before moving to more aggressive treatments. This can help in preventing the progression of obesity-related conditions.
  • 11mo
    To redefine patient identification for early and respectful obesity care, healthcare professionals should prioritize using person-first language, routinely calculate BMI as part of standard assessments, proactively discuss weight concerns with all patients, and actively seek opportunities to educate patients about the health risks associated with obesity, thereby expanding the scope of individuals considered appropriate for treatment; tools like motivational interviewing and a patient-centered approach can also be highly effective in engaging patients with obesity concerns.
  • 11mo
    Obesity as we practice now all pivots around BMI and that where the Stigma of it comes in the picture but need to look beyound it and more profoundly in to the overall health of the pt . Where as you need to address the weight of the patient for all the right reasons to manage it realsitically and practically attention needs to paid to Waist to hip ratio to stratify the health risks and pts should be encouraged to reduce it as it occurs in particular when they are exercising and the weight increases but the ratio decreases in addition to that attention should be paid to HTN , Lipids and the glycemic control which improves while there may not be substantial decrease in weight and this achievement should be used as marker for improved over all health rather than just on the weight numbers
  • 11mo
    I wrote a paper called Weighty problems related to which doctors put weight issues on the medical problem list. I strongly believe we need to get away from the terminology of obesity and simply use BMI and refer to BMI charts. I talked to patient about being in the pink zone and they can clearly see from the chart that that is obesity.
  • 11mo
    It is good to have the Edmonton obesity staging system, also taking into consideration comorbidities, patients preferences, insurance coverage , weight programs , nutrition counseling

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