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Patients want weight management in primary care, but regular office visits tend to focus on comorbidities, leaving little time to talk about weight.

Fam Pract Manag. 2023;30(6):19-25

This content conforms to AAFP criteria for CME.

Author disclosures: no relevant financial relationships.

weight management

Obesity is a critical public health issue that contributes to most of the leading causes of death in the U.S., including diabetes, cardiovascular disease, cancer, immobility, and mental illness. The Centers for Disease Control and Prevention estimates that 41.9% of adults in the U.S. have obesity (defined as a body mass index [BMI] of 30 or higher)1 and another 31.1% are overweight (BMI of 25–29.9).2 Many patients would like to lose weight but face barriers such as stigma, demotivation, low self-efficacy, cost, and poor access to care.3 However, recent research suggests that with the right structures to identify and address these barriers, primary care practices can deliver effective obesity care that helps patients lose weight, alleviating comorbidities and improving outcomes without contributing to stigmatizing “fat-shaming.”46

We implemented a weight management program for primary care rooted in the fundamental concept of the weight-prioritized visit (WPV). Half of the patients who participated in this model lost more than 5% of their body weight, including one-third who lost more than 10%, and almost one-fifth who lost more than 15%.7 Before implementing this approach, we never seemed to have enough time to address weight management adequately during office visits. The new program prioritizes weight management rather than focusing on obesity's sequelae, creating time for more comprehensive discussions. In a WPV, both patient and clinician understand the visit will be dedicated to talking about weight and co-creating a comprehensive, personalized treatment plan.

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