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Adding weight loss counseling to practice


More than two-thirds of adults in the United States are overweight, and about one-third are obese, according to NHANES data.

Key Points

More than two-thirds of adults in the United States are overweight, and about one-third are obese, according to data from the National Health and Nutrition Examination Survey (NHANES), a program of Centers for Disease Control and Prevention-sponsored studies designed to assess the health and nutritional status of Americans.

So no matter where you practice, significant numbers of your patients probably need to shed pounds, and many would appreciate your help in doing so. Indeed, a carefully designed and administered weight-loss counseling program is an add-on service that patients might agree to pay for out of pocket, and successful participants can be counted on to spread the word.

Read on for information on how to design and administer a program that can slim down your patients while beefing up your practice.

The National Institutes of Health advises primary care physicians to measure patients' height and weight and calculate body mass index (BMI) at the start of each visit, treating BMI-weight (in pounds) x 703 ÷ height (in inches) squared-as a routine vital sign. If a patient has a BMI of 30 or more, or a BMI between 25 and 30 and at least two weight-related health problems, then it's time to open a discussion about weight loss and, if the patient is receptive, explain how you can help.

"We encourage physicians to do group visits, because our research shows that these arrangements encourage greater [adherence]. But it's fine to go with individual counseling. The program is very flexible," McAndrews adds. "AIM-HI can be run by a nurse practitioner or a physician assistant, but the physician should have the initial conversation with the patient."

Pasternak tries to set up his office so that patients know the clinicians are interested in helping them lead healthier lifestyles. "Many of the magazines in our waiting room are associated with fitness and promote things like bicycling, running, and other outdoor activities," he says.

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