The number of people living with obesity has grown exponentially in
the past few decades.1 As a solo practitioner, there is a
clear medical need for the effective treatment of obesity. Currently,
the majority of treatment within obesity medicine is through
multidisciplinary teams. However, the ability of a multidisciplinary
team might be limited and may not be able to match the growing number
of treatment needs due to the great increase in the number of people
living with obesity. There is a clear need for healthcare
practitioners all around the world to have the capacity to treat
obesity if we are to put a dent into the significant number people
living with obesity and its associated comorbidities.
Developing an effective treatment protocol for a primary care doctor
without a multidisciplinary team is possible for the treatment of
obesity. If we look at other chronic conditions such as high blood
pressure and Type 2 diabetes, they were previously managed with
multidisciplinary teams as they were quite challenging to manage
effectively. Due to the lack of effective treatments the emphasis was
on behaviour change through will power and intense instruction, which,
unfortunately were still ineffective for the majority of individuals.
With the introduction of effective pharmacotherapy for both
hypertension and Type 2 diabetes, the ability to manage these
conditions improved and this allowed solo practitioners to treat these conditions.
Similarly, we are now seeing the potential for solo practitioners to
manage obesity as a result of the introduction of treatment guidelines
and effective therapies. The Canadian
obesity guidelines for adults living with obesity were
written with the solo practitioner in mind, giving physicians clear
direction with treatment algorithms to support patients living with
obesity.2 Lifestyle interventions, incorporating dietary,
exercise, and behavioral therapies should be implemented as part of
any treatment plan. Pharmacotherapy, combined with lifestyle
management, will likely be the main pillar that will allow us to have
effective sustained weight management. Cognitive behavioral therapy
(CBT) for weight management is best accessed and most effective if a
patient is already on pharmacotherapy that decreases hunger and
cravings, allowing for more effective psychological counselling.
Bariatric surgery also benefits from pharmacotherapy, as many patients
regain weight after bariatric surgery and need pharmacotherapy options
to get their weight back under control.
In today's world, there are many tools that a primary care doctor
has at their disposal to help with weight management. This includes:
Online resources to track dietary and caloric intake. These
often come with healthy dietary suggestions, and are accessible for
most people around the world.
Cognitive behavioral therapy is moving towards more virtual
means, supplemented with online resources. There are now apps that
incorporate CBT for weight management and online CBT courses such as
that are accessible to most patients.
- A solo practitioner
can use the resources of their local pharmacists to advise on
the appropriate administration and titration of weight management
pharmacotherapy, and to cancel out side-effect profiles.
All of these resources, helping with lifestyle management along with
effective pharmacotherapy and appropriate training, will now allow a
solo practitioner to treat obesity in an effective and successful
manner. This, in turn, will enable greater intervention on a broader
scale, allowing us to treat more people living with obesity than ever before.