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Doctors given guidelines on helping patients lose weight

Richmond Times-Dispatch (VA)


Nov. 25--Q: How should doctors advise patients who are overweight and want to lose weight?

Answer: It's not enough to tell them to just eat less and move more, said Dr. Anna Vedina, an internal medicine physician with HCA Virginia's James River Internists.

"I try to be more supportive. It's always easy to just say, 'You're obese and you need to exercise or eat better.' But if I see that is an issue and the patient is gaining more and more weight, I sit down and talk to them," she said.

Doctors were given more specific guidance on counseling patients about obesity recently when a panel of heart doctors and obesity experts issued revised guidelines on how to help adults lose weight and maintain the loss.

The American Heart Association, the American College of Cardiology and the Obesity Society developed the recommendations, which offer doctors an algorithm or flowchart of best practices to follow.

For instance, doctors should calculate a patient's body mass index (BMI), a measure of height and weight, and take the patient's waist measurement, at least once a year. To lose weight, women should follow a diet with 1,200 to 1,500 calories a day, men 1,500 to 1,800 calories a day, adjusted for physical activity.

The guidelines also address when weight-loss drugs and weight-loss surgery should become part of the conversation.

"We definitely measure the BMI," Vedina said. "We talk about exercise."

She said a lot of patients think they are eating healthy, but once she quizzes them about their nutritional choices, she finds otherwise.

"There are patients who cannot afford to eat fruits and vegetables. We go over what is better than what they are eating right now and that they can still afford," Vedina said.

The guidelines recommend patients work with a trained health professional, such as a registered dietitian or a trained weight-loss counselor, in a primary-care setting.

Vedina said if a patient is really motivated and they work out a treatment plan, she is willing to see that patient every month.

"Obesity has a very negative impact on a patient's health," Vedina said. "It is very important that we work with our patients and remind them how important it is to lose weight and be there for them to help them try to lose weight."


(c)2013 the Richmond Times-Dispatch (Richmond, Va.)

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Copyright Richmond Times-Dispatch (VA) 2013

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