Toolkit Helps Physicians Promote Healthier Weight

Physician advice carries a lot of weight in Vermont. Survey data from the Vermont Department of Health reveals that when a health care professional counsels a patient about their weight problem, 88 percent take active steps to shed pounds. Unfortunately, only 41 percent of obese adults in Vermont are counseled by their health care provider about their weight.

"More than half of all adults in Vermont are overweight or obese, and obesity is a big risk factor for many serious chronic diseases, including diabetes," said Health Commissioner Sharon Moffatt, RN, MSN. "When we measured how effective the advice of a health professional really is in motivating a patient to attempt behavior change to lose weight for their health, we wanted to make it easier for clinicians to have that conversation with their patients."

As a result, the "Promoting Healthier Weight in Adult Primary Care" toolkit was developed by the Vermont Department of Health, Vermont Area Health Education Centers (AHEC) and the University of Vermont College of Medicine. The toolkit was mailed to all Vermont primary care and family practice clinicians in September.

The toolkit - which includes recommendations for prevention, identification, assessment and management of overweight and obese adult patients in primary care - is also designed to aid the sometimes uncomfortable conversation about weight and health between clinician and patient.

The toolkit was developed with advice from primary care practitioners who responded to a survey on current practices and barriers to care. Practitioners from more than 60 percent of all practices in Vermont responded to the survey.

"Based on the survey, we learned that many physicians were having these conversations about diet and exercise, but there was not an easy way to document that discussion and follow up on it," said Richard Pratley, MD.

Dr. Pratley is a professor of medicine at the University of Vermont College of Medicine, who served as medical advisor on the project. "Our goal was to create a set of steps that could easily and effectively be incorporated into a short office visit."

Providing information, tools and resources to clinicians is a central focus of the Vermont Blueprint for Health - a comprehensive, proactive system of care to improve health and quality of life for people who have, or who are at risk for, chronic conditions.

Several Vermont primary care physicians tested the toolkit for everyday use in their practice. Charles MacLean, MD, professor of medicine at the University of Vermont College of Medicine and a primary care provider at Fletcher Allen's Given Health Care in Essex Junction, found it helpful to have the toolkit's standardized approach to talking with patients about obesity and weight loss.

"I found it improves the efficiency of talking to people because it provides specific ways of setting goals and helping patients work toward these goals," Dr. MacLean said. "One of the big things is the focus of the toolkit - it has a very specific goal-setting component."

Whether or not the toolkit will produce results in long-term weight loss will continue to be a "difficult proposition," according to Dr. Pratley, but it can start the process, which is very important.