Obesity Toolkit

The WCHQ Obesity Advisory Group created this toolkit to address both clinical and operational workflows for treating obesity in primary care practice. WCHQ members identified the chronic disease of obesity as a growing concern, and in response, developed measures, education and improvement activities. This has been a vital step to improve treatment of the disease. The group produced this toolkit to provide relevant information for both the clinical provider and the operational administrator to build a successful obesity treatment workflow.

Millions of people are living with obesity, and it is a disease that is often overlooked. Obesity is a long-term health problem that impacts overall health. In 2019, 32 percent of Wisconsin residents were living with obesity. Obesity is associated with medical conditions such as heart disease, hypertension, high cholesterol, and diabetes. Societal attitudes toward people living with obesity increase stigma and deter people from seeking help. Insurers often do not offer a universal benefit for obesity treatment making it difficult for people to engage in treatment.

The Objective

The objective of this toolkit is to encourage primary care practices to support their providers in managing the disease of obesity and to refer to specialty services when necessary. There are not enough obesity medicine providers to treat all the patients in need. Treating people in primary care settings increases health care capacity and improvements in health outcomes. This toolkit is a practical, usable tool for quick referencing and adoption. The final workflows were revisions of steering team member workflows that demonstrated success in their own practices and met the latest evidence-based, updated clinical guidelines and care models from professional medical societies and associations.

Intended Audience

This toolkit is intended for adult populations in primary care settings. Providers and administrators reviewing this toolkit should examine how best to adapt their practice and policies to meet the needs of their patient population. The intention is not to print off the toolkit in its entirety but to use it as a Provider reference tool to help guide conversations with patients about obesity, associated topics, and available options.

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How to talk to patients about obesity

Your patients have probably been stigmatized because of their weight, have negative feelings triggered by words (obesity, diet, exercise, etc.), and have some pre-conceived thoughts coming into their visit. Being thoughtful and seeking approval to have a conversation about obesity is a critical part of setting the stage for a successful dialog with a patient.

People First Language How can I best initiate a conversation regarding obesity with my patient?What sort of language should I use when discussing obesity with my patient?Polite intros to discuss obesity How can I learn more about weight bias and how to prevent it?Text Link

Lifestyle

Leftover chicken in a container, red onion, eggs and swiss chard

Lifestyle factors are listed in order of relative importance regarding facilitating weight loss. Initiating healthier eating and activity habits is a fundamental step in weight management. Regardless of your patient’s disease stage, healthy eating and physical activity plans are recommended by AACE/ACE. Primary focus should be lifestyle change with secondary options or pharmaceuticals and surgery.

Eating Plan Options Additional Dieting Information Sleep Physical Activity

Obesity Myths

Important Myths and Controversies Abstract

Patient Care Plan

Dr and patient talking in front of a chart and plant

Patient Care Plan Medication Surgical and Endoscopic Procedures Medication

Clinical Operations

Woman typing on a laptop with stethoscope

Billing and Coding Equipment and Supplies

Additional Resources for Providers

Dr writing notes in a notebook with a laptop on his desk

De-prescribing meds that cause weight gain Screening for co-morbidities Do I need to do a workup for secondary causes of obesity in my patient? How will patient's health risks improve with weight loss?

Additional Resources for Patients

Woman and trainer doing squats near a lake outdoors

We have all lived in a society that places responsibility for weight on individuals, not systems. People have been told that if they work hard enough, they should be able to lose weight and maintain loss. If this were true, it seems unlikely that ¾ of the population would have overweight/obesity. It is VERY hard to lose weight, and especially hard to maintain weight loss. This struggle should be normalized for patients.

74% of people have overweight or obesity
In some studies, 80% of all pounds lost are regained
Hunger hormones are upregulated, and metabolic rate is downregulated after weight loss

Weight Management Patient Information About Diets Patient Information About Sleep Patient Information About Medications Patient Information About Physical Activity

* Updated 2/23

Questions about the Toolkit
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WCHQ welcomes your questions and comments about this toolkit, which is intended to advance collaborative learning, open sharing, and collective improvement. Please contact the WCHQ at info@wchq.org.

Funding Support Provided by: