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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

4 Comments

  1. Arya,

    It is particularly heartening to read today’s posting. You know my personal story, probably better than anyone. There is no doubt in my mind that my local Primary Care Network and in particular, my primary care nurse, Danielle, saved my life. Absolutely no doubt.

    Primary Care Networks are, must be and must continue to be, just fundamentally key to winning the war on obesity and helping the thousands of people out there who are waging the daily battle struggling living with obesity to better manage their weight and all the related comorbidities.

    There is no question that obesity management starts at the primary care level.

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  2. I’d be interested to see the marketing of the first group.

    As I read the stats, the average loss is just under 9 pounds, and there are 173 patients among the 1,400 (12 percent) who have sustained losses of 20 pounds or more. These are, actually, impressive stats when compared with reality, but I have a feeling that consumers would not buy into a program if it marketed on the basis of a 9 pound sustained loss (as opposed to a hundred pound loss — asterisk: results not typical) because there is no understanding of reality. In reality, for most people a zero pound change over several years is an enormous victory.

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  3. I really like how this program includes a range of allied health professionals because the mental health professional could be just as important to an individual or possibly even more so then the dietitian and the nurses, the team improves the odds that a client could receive the customized support that would be most helpful to them.

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