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Intensive Lifestyle Interventions: Assessing the Impact

Intensive Lifestyle Interventions: Assessing the Impact

The number of adults who are overweight or obese and have type 2 diabetes is increasing rapidly throughout the United States. An estimated 35% of Americans are obese, and the number of U.S. diabetes cases has steadily risen to nearly 30 million. Alone, both obesity and diabetes can significantly increase healthcare costs, but these costs rise further when obesity and diabetes coexist. “It’s clear that strategies are needed to prevent obesity and diabetes, but it’s also important to improve how these conditions are managed when they develop,” says M. Sue Kirkman, MD. In recent years, clinical trials have been launched to test intensive lifestyle interventions (ILIs) aimed at promoting long-term weight loss and increasing physical activity. These interventions are recommended for overweight and obese individuals with type 2 diabetes. “ILI provides patients with education, support, and follow-up so that they can incorporate changes into their daily lives and overcome potential hurdles to healthy eating and exercise,” explains Dr. Kirkman. However, while it has been assumed that ILI can reduce healthcare costs, few studies have examined the long-term effects of these interventions on costs among obese patients with diabetes. Examining Long-Term Effects The Action for Health in Diabetes (Look AHEAD) study is a randomized clinical trial that has sufficient size and duration to test whether ILI influences long-term healthcare use and costs. A recent study in Diabetes Care was conducted in more than 5,000 overweight or obese adults with type 2 diabetes who participated in the Look AHEAD study. Patients were randomly assigned to an ILI that promoted weight loss or to a comparison group of diabetes support and education...
A Resource to Help Care for Obesity

A Resource to Help Care for Obesity

Few providers have the resources or time to implement guidelines for managing overweight and obese patients, according to Louis J. Aronne, MD, FACP. To overcome this obstacle, Dr. Aronne and other experts in obesity and weight-management care developed BMIQ (www.bmiq.com), a website that allows healthcare providers to add a comprehensive, office-based program to their medical practice. The BMIQ program registers patients during office visits and guides physicians on delivering obesity treatment modules. Patients are then given expanded session materials online and are guided to apply for sessions and plan meals as part of their daily routine. Patients can track their weight, food, and activity goals online. They are also encouraged to schedule their next office visit in order to participate in their next module. Enhancing Implementation “BMIQ can serve as a tool for patients and clinicians to enhance the implementation of evidence-based obesity management,” Dr. Aronne says. “For comprehensive obesity management to be effective, clinicians need a program that is easy to implement, flexible to use, and supports patients outside of the office setting.” The BMIQ Professionals Program accomplishes this mission for a low monthly subscription. Subscribers receive their own branded website along with other program components, such as complete program materials for clinicians and pa­tients, including session guides, patient lessons, and references. They also receive a complete 20-session program that can be delivered individually in the office setting, over the phone, or in a group setting. In addition, subscribers receive video tutorials on getting started and delivering each session as well as comprehensive reports for each patient who completes their online assessment. BMIQ provides integrated patient tracking, which...
On the Unity of Doctors

On the Unity of Doctors

Doctors are facing challenges like never before. Not only are new medications being discovered and novel technologies being implemented, we are being bombarded with new regulations. Years ago, people were talking about how to improve the doctor-patient relationship. Currently, all the journals are talking about big data, EHR, meaningful use, and ICD-10. Not only do we need to stay current with all the medical innovation taking hold, we need to learn how to comply with all these regulations. Many doctors feel these requirements are actually not helpful as being touted. In fact, we feel there is harm being done because they are taking us away from direct contact with the patient. According to a study out of the American Journal of Emergency Medicine, it has been estimated that ER docs spend 44% of time on electronic data entry and 28% on patient contact. Doctors are becoming increasingly vocal on speaking up against these regulations that we are forced to comply with. However, after years of being forbidden to unionize or collectively bargain, we are often doing it alone. We feel isolated in this sea of chaos. Polices will never change based on just one voice. If we are to drive policy change and shape regulations to become meaningful for the quality of medicine, we need to find a unified voice. How can doctors find unity and speak up against wrongful healthcare policies? 1. We can share information about these policy changes. We all need to stay up-to-date with them for our own practices. When we are aware, share them and discuss with other doctors why or why not these...
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