As of 2021, approximately 41% of adults between the ages of 20 and 30 in the United States are obese. Monica Orsborn, a Pharm.D., explained. Conference and Exhibition in Orlando, Florida. By 2030, one in two adults in the United States will be classified as obese, and as many as one in four will be classified as severely obese, according to Orsborn.

“We all know that obese people have a higher risk of coronary heart disease, high blood pressure, stroke, diabetes, and certain types of cancer. This is a real problem,” Orsborn said during the APhA session. Ta. “The United States is spending $173 billion.” [US dollars] Annual costs associated with obesity [prevalence]”

Mr. Osborn further added that obese people spend about $1,800 more annually on health care than people of a healthy weight, showing that the disease has economic consequences alongside its health consequences. I explained that there was.

“We started a multidisciplinary weight management clinic about six months ago,” Orsborn said during the session. “When we started the clinic, we wanted to look at the guidelines. The most common guidelines [used are] 2013 American Heart Association [AHA]/American College of Cardiology [ACC]/ Obesity Society Guidelines for the Management of Overweight and Obesity in Adults. Many of the newer drugs for obesity and weight management are not listed because they are a bit outdated.But most [the guidelines used] We recommend starting in the same place. ”

Orsborn explains that the starting recommendation is to lose 5% to 10% of your baseline weight within six months. However, AHA/ACC/Obesity Association guidelines recommend gaining this initial amount through lifestyle changes, according to Orsborn.

“We re-evaluate patients after six months and if lifestyle changes such as diet and exercise do not meet their goals, we [the guideline] We recommend determining the risks and benefits of weight loss medications,” Orsborn said during the session. “This is where we do most of our best work: helping people choose the right medicine for a particular patient.”

The AHA/ACC/Obesity Society guidelines recommend that this decision be based primarily on the patient’s comorbidities. But Orsborn said the American Diabetes Association (ADA) also has guidelines to help with this purpose and updates its recommendations annually. The ADA guidelines advise in their 2024 recommendations that it is best to choose hypoglycemic drugs because they are more effective in helping patients lose weight. In addition, Orsborn said her clinic also uses Obesity Medicine Association (OMA) guidelines to make treatment decisions and updates treatment recommendations annually. OMA guidelines recommend using the drug from the beginning for patients with a BMI greater than 30 or those with a BMI greater than 27 and one or more of her comorbidities. OMA then recommends that she re-evaluate the patient 12 weeks after starting obesity treatment.

OMA guidelines recommend using the drug initially for patients with a BMI greater than 30 or those with a BMI greater than 27 and one or more comorbidities. Image credit: © InputUX – Stock.adobe.com

“If you need further weight loss or are also working on your A1c, you can change your medication or increase your dosage more intensively,” Orsborn said during the session. “these [OMA] The guidelines differ in that they also provide helpful information about when patients should be referred to a weight and obesity specialist or bariatric surgery. ”

Osborn noted that she and her colleagues started the clinic because most of their patients were diabetic and were already using weight-loss drugs. However, because it wasn’t a weight management clinic at the time, there wasn’t much guidance or follow-up to offer patients.

“So I said, ‘Okay, let’s get started,'” Orsborn said during the session. “Once we have patients referred to us, we can begin a more comprehensive approach. [our patients’ weight loss efforts] You can be more successful while helping people with diabetes. ”

The clinic began by supporting patients with lifestyle changes, including behavioral interventions, healthy eating, and physical activity recommendations, as well as medication, as guidelines recommend, Dr. Orsborn explained. .

“But we also recognize that we are advocating for our patients by doing this. We are actually providing them with more education than if they were simply seeing their primary care provider.” We were giving them more support. We were giving them more attention and actually giving them options for intervention,” Orsborn said during the session. “This has allowed us to help patients make their own choices regarding their plans of care. It has also helped people learn how to eat healthier, be more physically active, and It can also be empowering. [manage their] behavioral health. Some of them can also be referred to receive more behavioral health support if they wish. ”

When considering each patient’s care plan, the clinic worked to ensure it was SMART (Specific, Measurable, Achievable, Relevant, Time-bound) goals. According to Osborn, this has ensured a more patient-centered approach to care.

Additionally, Orsborn said her role as a pharmacist in a multidisciplinary weight management clinic involves examining patients’ risk of obesity, assessing appropriate weight loss goals for them, suggesting slight changes, and understanding why patients are losing weight. He explained that the idea was to discuss whether they wanted to reduce the She approaches the role of medicine with patients and discusses potential side effects of medicines with patients.

“Effective educational strategies are what motivate patients to want to lose weight,” Orsborn said during the session. “[We also use] Conduct motivational interviewing and implement shared decision-making to get patients more involved in their own care. ”

reference

Orsborn M. The role of the clinical pharmacist in an interdisciplinary weight management clinic. American Pharmacists Association 2024 Annual Meeting and Exhibition; March 22-25, 2024. Orlando, Florida.