Weight Management in Primary Care – More Than Just Lifestyle

Dr. Clarke and his 'Lifestyles' team, Cardston, AB

Yesterday, my role as Clinical Co-Director of Alberta’s Provincial Obesity Initiative took me to the “South Zone” of our province, where I visited primary care colleagues in Cardston and Pincher Creek (both part of the Chinook Primary Care Network).

In Cardston, I was welcomed by Dr. Clarke and his team that offers a “Lifestyles’ program to patients at their clinic. Variants of this program have been in operation for the last six years and the current team includes LInda, a Registered Nurse “Lifestyle” Lead and Shelly, a Licensed Practical “Lifestyle” Nurse Educator – the lifeblood of the program. Other members include a mental health counsellor and a registered dietitian as well as admin and data analyst staff.

According to Dr. Clarke, the program started in 2006 with one RN and has enrolled about 1400 patients to date (for a total weight loss of over 12,000 lbs and counting). More important than the absolute amount of weight lost, is the fact that 56% of their patients appear to have maintained much of their weight loss – some for several years now.

An impressive 10 patients have lost over 100 lbs, 18 patients have lost 50-100 lbs, 145 patients have lost between 20-50 lbs.

A recently started CORE Strength Program targeting adolescents has so far enrolled 40 youth and early results appear promising.

The important issue here, is that these services and successes were entirely funded out of the clinic’s primary care budget with minimal cost to patients – clear evidence that successful weight management is indeed possible in a rural primary care setting.

My second stop was in Pincher Creek, another small rural Southern Alberta community, where I was greeted by the primary care team and learnt about their interest and ideas about obesity management in complex patients. Dr. Irving, one of the physicians in the clinic, proudly presented some of his weight management results – again some very impressive sustained weight loss.

I was particularly pleased to see how this clinic has already embraced my 4 M’s of obesity assessment and the Edmonton Obesity Staging System. Again, a sign that obesity management is achievable in a primary care setting and can very much improve the health of patients with weight-related comorbidities.

Overall, this intense day of interaction with passionate and enthusiastic frontline health providers, leaves me optimistic that clinically meaningful obesity management can indeed be integrated into primary care.

As I have said before, obesity is a very treatable and manageable condition if we only put the same resources into preventing and treating obesity as we put into managing other health problems.

AMS
Edmonton, Alberta