New guidelines on the management of adult obesity in primary care recommend that reducing waist circumference should be considered even more important than weight loss, as it is linked to a decrease in visceral fat and associated cardiometabolic risks.
The guidelines, published in Obesity Facts, the European Journal of Obesity, provide practical guidance on the clinical evaluation of obesity and metabolic syndrome, as well as guidance on obesity treatments.
It says, as the first objective of treatment is to stabilise weight, the general practitioner may monitor weight loss and waist circumference every one to two weeks during the first months to evaluate the efficiency of the treatment plan. This can be reduced to monthly after six months.
The guidelines also highlight the importance of communication in the treatment of obesity and say it is important to welcome the patient to the medical practice with empathy and without negative judgment or bias. “We must acknowledge that the discrimination and stigmatisation of patients with obesity is surprisingly common in healthcare setting,” the authors say, highlighting the deleterious consequences of such stigmatisation.
The guidelines recommend the use of motivational interviewing to increase patient’s motivation to change and their confidence in the therapist and treatment.