Obesity affects over 40% of adults in the US and the numbers keep going up. Even though experts have a good understanding of what causes obesity and how to treat it, this knowledge isn’t always used in clinics, which could be slowing down progress in reducing heart disease rates.
New research on the root causes of obesity and the best ways to treat and manage it has led to disparities in how the latest scientific findings are applied.The medical treatment for individuals with obesity varies widely depending on the healthcare provider and institution. This information is outlined in a recent scientific statement by the American Heart Association, titled “Implementation of Obesity Science Into Clinical Practice,” which is published in the journal Circulation. Deepika Laddu, Ph.D., F, stated that obesity is a significant public health issue in the United States and globally, affecting nearly all demographics and putting a strain on healthcare systems.AHA, chair of the statement writing committee and a senior research scientist at Arbor Research Collaborative for Health in Ann Arbor, Michigan, stated, “Obesity is a major risk factor for heart disease and has been a significant obstacle in reducing heart disease rates. Despite progress in understanding obesity and new treatment options, there are still major gaps between obesity research and its practical implementation in clinical practice.” Studies indicate that intensive lifestyle therapy is much more effective for weight loss than brief advice from a healthcare professional. However, general educational information is often provided instead.health professionals are more likely to recommend lifestyle changes rather than sending people to classes or programs. A study found that only 16% of health care professionals knew about evidence-based lifestyle treatments for obesity, such as diet, exercise, and behavioral therapy. Socioeconomic and racial disparities also make it harder to address weight loss. People from different racial and ethnic backgrounds, as well as those covered by Medicare or Medicaid, are less likely to be referred to weight management programs or have them covered by insurance.Insurance.
The global population of people with obesity is on the rise. Over the past 30 years, the prevalence of obesity in the United States and worldwide has been increasing. Recent data suggests that more than 40% of U.S. adults aged 20 and over are affected by obesity, as reported by the U.S. Centers for Disease Control and Prevention.
Research has enabled experts to uncover the various causes of obesity, which include social and physiological factors related to health. Treatment options for obesity have also advanced, with a focus on lifestyle changes, medication therapy, and bariatric (weight-loss) surgery.
However, every method of treatment has its own set of difficulties.
“Even though we have made significant progress in the field of understanding obesity, there is still a considerable gap between knowledge and its practical application in medical practice,” stated Laddu. “Healthcare providers and systems need to find more effective ways to implement our understanding of obesity so that more individuals can receive the proper support and treatment. This could involve the adoption of new technologies and telemedicine, referring patients to community-based weight management programs to promote behavioral change, offering social support, and increasing the accessibility of treatment.”
There are several promising methods that we could use to provide successful, evidence-based obesity care. Weight loss medications, such as high-dose semaglutide and tirzepatide, have been recently approved by the FDA for long-term weight management. Clinical studies have shown that these medications are associated with an average weight loss of more than 10% at six months. Despite half of adults in the U.S. meeting the BMI criteria for obesity and being eligible for these medications, only a small proportion of this population is currently taking them. Until recently, the pPrimary obstacles to increased use of anti-obesity drugs included lack of insurance coverage and high out-of-pocket costs for these medications.
Starting from the launch of the Medicare (Part D) program in 2006, all medications used for weight loss were not covered as part of basic coverage. In March, the Centers for Medicare and Medicaid Services (CMS) announced that Medicare and Medicaid could provide coverage for the anti-obesity drug semaglutide, once it receives FDA approval for an additional use. This decision also included high-dose semaglutide, which is approved by the FDA for weight loss and reducing the risk of cardiovasc.The risk of premature death, heart attack, and stroke is higher in adults with cardiovascular disease who are obese or overweight. State Medicaid programs, which provide healthcare for low-income individuals who are more likely to be affected by obesity and heart disease, must cover almost all FDA-approved anti-obesity medications for those who meet the health and body mass index (BMI) requirements. However, state health plans may require patients to try other treatments or medications before they can use GLP-1 medications. “FDA approval and insurance coverage for the newest treatments, such as GLP-1 medications, are crucial for improving the health outcomes of individuals with obesity and heart disease.The Vice Chair of the scientific statement, Ian J. Neeland, M.D., FAHA, who is also the director of cardiovascular prevention at University Hospitals Harrington Heart and Vascular Institute, highlighted the importance of improving access to care for those in need of therapies, particularly high-risk patients. He also expressed optimism that these efforts could lead to a decrease in the risk of cardiovascular disease and better outcomes for millions of adults in the U.S. with potentially positive results.The associate professor of medicine at the Case Center for Diabetes, Obesity and Metabolism at Case Western Reserve University School of Medicine in Cleveland specializes in weight loss surgery. Over the years, there have been improvements in the safety and skill of bariatric surgery, as well as a better understanding of the health benefits that often follow. Research has found that patients who have undergone weight loss surgery have a reduced risk of cardiovascular disease and reduction in risks for various other obesity-related conditions, such as Type 2 diabetes and hypertension. A key obstacle for healthcare providers is to guarantee that the most vulnerable populations have the means to afford bariatric surgery, as well as the necessary resources and social backing.
The statement outlines approaches that tackle these obstacles and enhance the integration of obesity research into clinical practice. It also acknowledges the necessity to devise strategies that cater to diverse populations in order to address obesity on a community-wide scale. Potential enhancements in public health policies could be a result of these efforts.and future research is recommended to further develop patient care models and improve the delivery and longevity of fair obesity-related care.
The statement highlights specific approaches to help close the gap between obesity science and clinical care, including:
- Healthcare professionals may consider how social determinants of health, such as insurance type, household income, race and ethnicity, environment, health literacy, access to health-promoting resources, and social supports, influence the success of patient treatment in reaching and impacting populations in need.Education for healthcare professionals covers the intricate origins and clinical effects of obesity. This training should highlight the diagnosis, prevention, and treatment of obesity. Despite the widespread occurrence of obesity globally, there is a shortage of educational programs focused on obesity for medical professionals.Additionally, there is a need to assess health policy changes that healthcare systems and insurance plans can adopt and expand to make obesity treatment accessible for patients, particularly those at high risk for adverse outcomes like cardiovascular disease.The article reviews a framework for providing obesity care in clinical practice settings, as well as the efforts of professional societies to develop interventions that make obesity treatment more accessible.
“The statement highlights the significance of a comprehensive approach across various levels of health care delivery and public policy, as well as the implementation of feasible, evidence-based strategies in clinical settings,” stated Laddu. “It also emphasizes the necessity for future research and policy modifications to enhance current patient care models and guarantee fair access to obesity-related care for individuals in underrepresented groups.”
The scientific statement discusses potential solutions for assisting individuals in their daily lives, such as using digital technology and telemedicine for interventions. However, further research is necessary in the field of obesity science and treatment. The lack of understanding regarding the cost-effectiveness of obesity prevention and the long-term health effects of established therapies has been a barrier to incorporating obesity science into clinical settings. Collaborative research between stakeholders and health economists may help in developing and expanding cost-effective obesity science.
Prevention programs have proven to be effective.
Additional research is being conducted on Food Is Medicine methods in health care, such as medically tailored meals and produce prescriptions, to prevent and treat cardiovascular disease and other diet-related diseases. These approaches are being explored in various settings including the Association’s Health Care by FoodTM initiative.
The volunteer writing group prepared this scientific statement on behalf of the American Heart Association Obesity Committee of the Council On Lifestyle and Cardiometabolic Health, the Council on Epidemiology and Prevention, the Council on Clinical Cardiology, the Council on Hyp.Hypertension; the Council on the Kidney in Cardiovascular Disease; and the Council on Cardiovascular and Stroke Nursing are all part of the American Heart Association. The purpose of their scientific statements is to increase awareness about cardiovascular diseases and stroke, as well as to help people make informed decisions about their health care. These statements outline what is currently understood about a topic and identify areas that require further research. It’s important to note that scientific statements do not make treatment recommendations, but they do inform the development of guidelines. The American Heart Association guidelines are the official clinical practice recommendations of the organization.
