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Overweight and obesity: a clinician's perspective.

NC Med J July/August 2006, Volume 67, Number 4 In recent years, much has been published in the medical and lay literature on overweight and obesity. The most current United States data show that in 2003-2004, 32.2% of adults were obese and 66.3% were overweight or obese. The increasing prevalence over the past three decades, the associated disease comorbidities, and the attributable healthcare costs of obesity have been well documented. Various etiologic factors for the relatively recent increase in weight have been described, many of which involve a permissive environment that promotes a sedentary lifestyle and increased energy intake. For these reasons, obesity is one of the major public health challenges the United States is facing. If overweight and obesity are a public health problem, does it not require a public health solution? What can healthcare providers do in their office to make a meaningful impact on a problem that affects two-thirds of their adult patients? Compounding the challenge to clinical treatment of overweight and obesity are the limited appointment time and reimbursement available to most clinicians. While the impediments to effective treatment of obesity are real, healthcare providers can stimulate individual and collective changes in their patients by following a specific, efficient, and systematic plan. Listed below are elements of a general plan to treat overweight and obesity for the busy clinician.