to the editor: In Dr. Rao's excellent article, he recommends several strategies and identifies specific behaviors to facilitate weight loss among obese patients. Another strategy that can be implemented by any family physician is a group weight loss program. These programs combine interdisciplinary health care professionals and may be of tremendous value in achieving and maintaining weight loss.1
I created and oversaw such a program between February 2006 and October 2007 at our institution and witnessed how the group was able to make specific recommendations tailored to each individual patient. These practical weight loss tips were generated by patient members of these groups. Examples included taking the stairs instead of elevators, writing down what you eat and how you feel, eating three meals per day, and parking a block away from your destination. Each group came up with specific dietary interventions that could be applied immediately and reinforced at subsequent weekly check-ins.
Dr. Rao also did not recommend measurement of waist circumference for management of obesity in the office setting. Waist circumference is one of the five parameters that help identify the metabolic syndrome, which places patients at much higher risk of cardiovascular-related morbidity.2 In the group weight loss program, I found that this maneuver was easily taught to medical assistants, and patients readily accepted this step as part of their check-in and appreciated the immediate feedback.