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24min
Obesity care reimagined: Integrating chronic disease management and sustained interventions.

Obesity is a multifaceted, escalating global health crisis, affecting over a billion people in 2022 and projected to impact more than half the adult population by 2050. As a chronic, relapsing, multifactorial disease, it increases the risk of serious non-communicable diseases (e.g., type 2 diabetes, cardiovascular diseases, certain cancers) and contributes to over 5 million deaths annually. The global economic burden is projected to reach $4.32 trillion by 2035, alongside psychosocial challenges such as stigma, low self-esteem, and social isolation.

For adults with a BMI ≥30 kg/m², or ≥27 kg/m² with at least one obesity-related comorbidity, pharmacologic therapy should be considered when lifestyle interventions alone fail to achieve ≥5% weight loss after 3–6 months. When paired with behavioral and lifestyle measures, long-acting, once-weekly GLP-1 receptor agonists have been associated with substantial, sustained weight loss (e.g., a mean 12.1% reduction in body weight) and improvements in BMI, waist circumference, and blood pressure.

Viewing obesity as a chronic disease means shifting from short-term fixes to long-term care strategies. Management should address genetic, metabolic, environmental, and social drivers while evaluating the impact of functional limitations and emotional factors—such as psychological distress, stigma, and disordered eating—that may compromise adherence. Personalized care, aligned to each patient’s clinical, functional, and psychosocial profile, is essential for durable outcomes.

How can functional and emotional burden assessments be systematically integrated into obesity care to improve adherence and outcomes? What strategies can HCPs use to embed these therapies into long-term care plans that integrate pharmacologic, behavioral, and lifestyle support?

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  • 24min
    Having a set of task swill aid. Having better coverage is critical either way.
  • 3h
    Patients need evaluation and ongoing management. to fain success and offer positive re-enforcement. In person weight checks with prescription renewal, and having face:face encounters help me
  • Yesterday
    Right now it is difficult to find time to counsel pts on emotional burden, depression screening, diet counseling, etc. we should all work together with PCPs, dieticians and online resources. I frequently refer pts to Pharma website, there are many free resources there but pts frequently prefer to get education from the physicians
  • Yesterday
    There seems to be many patients who have a GLP – one deficiency. Simple replacement causes profound changes in the way they deal with food resulting in significant weight loss. Barring these responses, the most effective therapy is surgical. I have seen very few patients, although some, reason their way out of this situation with expert support.
  • Yesterday
    When patients begin to see progress, continue to encourage them to continue long term lifestyle changes in additional to GLP-1 really helps patients. As they continue to lose weight, positive reinforcement really helps to make long term changes.
  • Yesterday
    Optimal managemnt of Obesity on long term basis does include comprehesive evaluation and management of the Psyho social , Co Morbid and economical attributes .Ignoring any of these will be deterimental to long term success , Low self esteem , anxiety and derpession needs to be taken in to account and manage comprehensively with therapy and with pharmacological agents ,Pt needs to be positively reinforced for the weight loss on regular basis on reguaar basis ,Lower cost alternatives like Compounded versions need to be offered for the afforability constrains and need to be reminded that managing obesity is life long campaign like any other chronic disease
  • Yesterday
    Embed functional and emotional screening alongside BMI, A1C, and BP at baseline and follow-up, framing them as routine—not optional—to reduce stigma and improve disclosure.

    Functional improvement (mobility, pain)
    • Emotional well-being
    • Cardiometabolic risk markers
    • Medication persistence
    • Patient-reported quality of life
  • Yesterday
    So the functional and emotional assessment should be a part of your initial assessment. Helps to formulate motivation for long-term compliance. If you can run, remind a patient why they started sometimes that helps you through the middle portion of the road to get to the end of the journey as far as strategies to accommodate those goals, medication coaching, and positive reinforcement as well as goalsetting our major pieces to that long-term plan if it all possible you’d like to involve other specialties personal trainer nutritionist sometimes online apps to supplement what you’re doing in the office space
  • 2d
    We have a medical assisted weight loss program at our clinic where the patient will have a health coach, pcp and glp-1 for weight loss. We also have counseling available at our office as well if needed. These things are a must to help set the patient up for life and not just temporary weight loss w/ medications. There's also binge eating disorder, stress eating, anxiety, depression that needs to be evaluated and assessed during our visits to see if that is contributing to the person's obesity. As well as heart disease, DM, hypertension that needs to be addressed.
  • 2d
    As a PCP , I am in a unique and enviable position to get to know my patients as a whole and not just the diseases they suffer from. I am in solo practice which is an added bonus. nutritional counseling, emotional support, medications and training for injectables are largely provided by me although my patients also see a nutritionist at the beginning of their weight loss journey. Compliance seems to be less if a problem with AOM since it is quite gratifying for patients to see the numbers on the scale go down
  • 2d
    Long-term care plans should incorporate multidisciplinary teams including physicians, registered dietitians, behavioral health specialists, social workers, and when appropriate, bariatric surgeons. Treatment strategies must integrate pharmacologic, behavioral, and lifestyle interventions tailored to individual patient needs and cultural preferences.
  • 2d
    Best is time spent with patients to learn about the life which helps with emotional and functional burden. Time is precious so often this takes more than one visit and sometimes over years. Builds a strong provider and patient relationship.
  • 3w
    Many people have an underlying emotional issues linked to both causing their obesity and being obese. I feel psychotherapy is a very important part in becoming successful when starting a successful weight loss journey. Referral to a therapist who specializes in eating disorders and emotional eating can be helpful. When I talk to people about weight loss journeys, I encourage small incremental increases in physical activity, specifically strength training. Along with these recommendations, the GLP-1 medications offer assistance with appetite, "food noise" and help patients be successful and see results while on this journey. Frequent follow up in the office to reinforce goals and care plans is essential to helping patients be successful and remain successful in their journeys.
  • 3w
    More important is changes in lifestyle/diet and keep the way off not sure how long you keep pt on the meds unless they are diabetic. Not sure how long commercial insurance will keep covering. Medicare coverage low price will not happen until 2027
  • 4w
    Until insurance covers treatment options like any other disease and patients can therefore afford treatment, any thing we do serves no real purpose.
  • 4w
    So many are frustrated by prior failed attempts at weight loss and many just accept this is their fate. I takes time to encourage patients to consider other options and approaches.
  • 4w
    Comprehensive evaluation should move beyond BMI to incorporate medical and psychosocial assessment during initial and follow-up encounters. Reviewing patients' prior experience with weight management, their perceptions about benefits of weight loss, and their values is particularly useful. Clinicians must address weight stigma and bias
  • 4w
    You need to spend more time talking to the patient to assess the emotional burden and diffuse it by letting them know they are not alone.
  • 1mo
    Ideally all of my patients with obesity can join one of our lifestyle groups that addresses alot of these issues and lends a tremendous amount of support to the patient.
  • 1mo
    Obese patients have been told for years that they are at fault for their obesity. Lack of discipline in eating and lack of exercise. These myths must be broken and that obesity is a chronic illness like high blood pressure and high cholesterol and diabetes and needs to be managed with medication and physician guidance to help achieve desired goals. Also this includes use of other behavioral modalities
  • 2mo
    It is a great time to practice Bariatric medicine with the slew of the choices available paritcularly in GLP-1 class and related meds and has given a new dimension in managing obesity and their benefits go beyond just weight loss and diabetes in to improved CV , Renal and Sleep Apnea positive outcomes As much these meds have a bilogical effect in achieving these results cornerstone and pivotal aspect is individualizing the management and that stems from educating pts in the holisitic aspect of weight management in understanding and incorporating the diet , exercise and lifestyle modifications and taking their psycho social and economic factors in consideration ! So detailed analysis and evaluation of these aspects should be done before embarking on the medical therapy and needs to be drilled on every visit in to the psyche of the pts , Collobration with a dietician , psyhcotherapy if needed , enrollment in to structured exercise program or home work out routine with the help of the apps , Enouragement and rewards on achieving the goals and above all need to be reminded that Obesity is a chronic disease and needs to be managed in the same perspective and intensity like HTN , Diabetes and Hyperlipidemia to achieve realistic goals
  • 2mo
    • Better targeting: EOSS + PROMs identify who needs more than calories-in/calories-out. 
    • Adherence drivers: Tracking function, QoL, stigma, and eating symptoms surfaces the real barriers to taking meds and showing up. 
    • Evidence-aligned meds: Long-acting, once-weekly incretin therapies produce the largest average losses with lifestyle support, and switching/intensifying when needed is guideline-concordant. 
  • 2mo
    by working with mental health, nutrition and when necessary with CDE and psychology to improve and detect social barriers and decrease potential stressors linked to noncompliance and making bad nutritional/lifestyle choices ; identifying financial stressors and applying for financial help when possible ; connecting to local food banks and church organizations for help .

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