Expert panel provides practical advice for managing overweight and obesity in clinical practice
PHILADELPHIA, March 14, 2023 – On March 8, the American College of Physicians (ACP) and Annals of Internal Medicine hosted the first virtual forum on the current clinical challenges related to managing overweight and obesity in clinical practice. During the forum, a panel of experts discussed three specific cases representing common clinical scenarios and answered audience questions about each of them. The panelists shared pragmatic clinical information and a replay of the full discussion is freely available to ACP members. The video and accompanying editorial from Christine Laine, MD, MPH, FACP, Senior Vice President of ACP and Editor-in-Chief of Annals of Internal Medicine and Christina Wee, MD, MPH, Senior Deputy Editor of Annals of Internal Medicine were published today in Annals of Internal Medicine.
“Overweight and obesity now affects more than 40 percent of Americans and is associated with an increased risk for many common and serious illnesses,” said Dr. Laine. “Just as important, persons with obesity suffer from stigma, in large part because the condition has been erroneously viewed as a condition brought on by a person’s own unhealthy behavior. In this forum, experts not only provide practical advice on management, but also help to dispel some of the misconceptions surrounding obesity that may contribute to unconscious bias among internal medicine physicians who are on the front lines treating these patients.”
Dr. Wee, who is also an obesity researcher and Associate Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center, served as moderator for the forum and introduced each of the panelists. These included:
- Anita P. Courcoulas, MD, MPH, Anthony M. Harrison, MD Chair and Professor of Surgery Chief, Minimally Invasive Bariatric & General Surgery University of Pittsburgh Medical Center.
- Sharon J. Herring, MD, MPH, Associate Professor of Medicine Director, Program for Maternal Health Equity Center for Urban Bioethics Lewis Katz School of Medicine, Temple University.
- Melanie R. Jay, MD, MS, Associate Professor Department of Medicine and Department of Population Health NYU Grossman School of Medicine Veterans Affairs, New York Harbor.
After hearing the clinical vignettes, the panelists provided their recommendations for addressing the unique circumstances surrounding the patient’s overweight or obesity. The panelists made several important points, all of which are detailed in the forum editorial. Of note, they stressed that obesity is a complex medical condition resulting primarily from an interaction of genes and the environment. This distinction is crucial because physicians need to be able to discuss weight with patients without assigning blame or shame. “It also goes a long way in explaining why modification of diet and exercise is difficult to achieve,” notes Dr. Wee.
To solve a problem, one must be able to define it accurately. As such, the panelists discussed the importance of developing a better and more inclusive measure of overweight and obesity. Body mass index, or BMI, the current standard of body composition, is an imperfect measure that differs with ethnicity, sex, body frame, and muscle mass.
"In addition to better measures of obesity, we need better strategies for treatment," said Dr. Wee. "Studies show that diet and exercise alone are unlikely to result in long-term obesity benefit. The good news is that we now have effective pharmacological and surgical therapies that may need to be considered as part of a multi-component intervention for appropriate patients. Of course, shared decision-making is an important part of this approach."
The forum, Overweight and Obesity: Current Clinical Challenges, was the first forum of its kind hosted by ACP and Annals of Internal Medicine. Previous forums focused on the infectious diseases COVID-19 and MPox, and another forum focused on the physician’s role in preventing firearm injury.
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About the American College of Physicians
The American College of Physicians is the largest medical specialty organization in the United States with members in more than 145 countries worldwide. ACP membership includes 160,000 internal medicine physicians, related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on Twitter, Instagram, and Facebook.
About Annals of Internal Medicine
Annals of Internal Medicine is the flagship journal of the American College of Physicians (ACP). Annals is the most widely read and cited general internal medicine journal and one of the most influential peer-reviewed clinical journals in the world. Annals’ mission is to promote excellence in medicine, enable physicians and other health care professionals to be well-informed members of the medical community and society, advance standards in the conduct and reporting of medical research, and contribute to improving the health of people worldwide. New content is published every Tuesday at Annals.org. Follow Annals on Twitter and Instagram @AnnalsofIM and on Facebook.
ACP Media Contact: Andrew Hachadorian, (215) 351-2514, AHachadorian@acponline.org
Annals Media Contact: Angela Collom, (215) 351-2653, ACollom@acponline.org