Obesity Prevention and Management

[2013 new]

Introduction to this self-study CME activity

Purpose

During the past 20 years, obesity has dramatically increased in both children and adults in the United states.  Obesity is a risk factor for most major causes of death.  The direct medical cost of overweight and obesity combined is approximately 5% to 10% of U.S> healthcare spending.  For individuals identified as obese, the person – not the obesity – should be the focus of treatment.  This self-study activity provides practical guidance to clinicians about diagnosing and treating overweight and obesity based on available empirical evidence.  Key aspects of care include:

Prevention for all patients:  lifestyle factors for the entire family – healthy diet, regular activity, and adequate sleep.

Management of overweight/obese patients

  • Medical home team approach to goal setting and making changes for patients at elevated BMI or who are crossing BMI percentiles.
  • Focused physical exam including blood pressure and heart rate, looking for signs of comorbid conditions.
  • Consider laboratory studies including cholesterol panel, fasting glucose or HgB A1C, AST and ALT.
  • Weight control:
- For children, decreasing rate of weight gain.
- For adults, gradual weight loss up to 2 lbs/week.
  • Medications are second-line therapy and use can be limited by side effects and safety profile. Be aware many common medications can precipitate weight gain.
  • For patients making inadequate progress toward their goals, consider referrals to dietitian, social work, multidisciplinary weight loss clinic, or bariatric surgery.

Objectives

 Participants in this CME activity will understand and be able to implement evidence-based cost-effective clinical strategies for the diagnosis and treatment of overweight and obesity in children and adults. 

Audience

This self-study activity is appropriate for primary care clinicians and other health care providers who diagnosis and treat overweight and obesity in children and adults.

Authors

Team Leaders

  • Kelly A. Orringer, MD
    General Pediatrics

Team Members

  • R. Van Harrison, PhD
    Medical Education
  • Satyen S. Nichani, MBBS
    General Medicine
  • Margaret A. Riley, MD
    Family Medicine
  • Amy E. Rothberg, MD
    Endocrinology
  • Lori E. Trudeau, MS, RD
    Nutrition Services
  • Yvette White, RN, CPNP, MS, MHSA
    Ambulatory Care Services

Author Disclosures

None of the members of the guideline team have a personal financial relationship with a commercial interest whose products or services are addressed in this guideline.

Other Acknowledgements

UMHS Guidelines Oversight Team

  • Grant Greenberg, MD, MA, MHSA
  • R. Van Harrison, PhD

Literature Search Services

  • Taubman Medical Library

Production of Internet Format and Website Maintenance

  • Ellen Patrick, MA

CME Accreditation and Credit Designation

The University of Michigan Medical School is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The University of Michigan Medical School designates this enduring material for a maximum of 1 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This CME activity was released in July 2013, with credit available through June 2016. The activity was reviewed for currency of content in June 2016 and availability of credit extended through June 2019. Continuation of credit from that date depends on a thorough review of the content currency and accuracy.

Method of Participation

  1. View the web pages. You may print the self-study text to read off-line.
  2. Complete the on-line learning assessment test with a score of 70% or higher.  After you initially take the test, the test will be immediately electronically scored. 
    If fewer than 70% of the questions are answered correctly, the questions that were not answered correctly will be noted in red.  Review the CME content related to those topics and retake the test.
    If 70% or more of the questions are answered correctly, the correct and incorrect answers for all questions will be shown along with explanations of the basis for the correct answer.  The link to register and receive credit is shown at the end of the items and explanations. 
  3. Complete the electronic credit request and activity evaluation.  An electronic certificate of participation will be provided immediately.
  4. Print the certificate of participation for your personal records.