1. RE:"National survey of US primary care physicians' perspectives about causes of obesity and solutions to improve care"

    It was with great interest that I read Dr. Sara Bleich's study on primary care physicians' perspectives on treating obesity. Unfortunately, I wasn't shocked by the findings.

    Obesity is an incredibly challenging condition to treat, and when facing a crisis as great as the United States' obesity epidemic, extraordinary steps are called for.

    Primary care physicians need to be aware of the current recommendations on body mass index screening, and understand that treating obesity takes diligence, empathy, creativity, and persistence.

    Also, primary care physicians need to be aware of the resources available to them, such as the American Academy of Family Physicians' efforts to equip its members with evidence-based tools and information to promote healthy lifestyle practices among their patients.

    The AAFP's Americans In Motion -- Healthy Interventions (AIM-HI) program, which was created by family physicians for family physicians, seeks to position fitness as the "treatment of choice" for the prevention and management of chronic conditions.

    Behavioral changes require motivation, and patients perceive physicians who practice healthy personal behaviors themselves as more credible and better able to encourage healthy lifestyle choices. With this in mind, clinicians and office staff are encouraged to use the AIM-HI educational tools and resources to improve their personal fitness, defined as physical activity; healthy eating; and emotional well-being, and to promote fitness for their patients.

    To support their patients in achieving better health, AIM-HI offers physicians a set of helpful tools including: * a fitness inventory, which gauges a patient's confidence about their fitness and their readiness to change; * a food and activity journal, which helps patients track nutrition and fitness goals; and * a fitness prescription, through which the patient and the physician establish mutually agreed-upon goals that are assessed periodically.

    Research shows the AIM-HI program leads to successful outcomes across a wide-range of patient populations from rural, suburban, and inner-city clinics and among a wide-range of ethnic populations. Fitness improvements for the patients were found in following three areas from baseline to 10 months:

    * a 10 percent increase in the number of patients reporting the same amount of physical activity; * a nearly 42 percent increase in the number of patients who ate at least a half serving more of healthy foods each week, and a nearly 45 percent increase in the number of patients who ate at least half a serving less of unhealthy foods each week; * and nearly 12 percent of patients lost 10 pounds or more.

    Helping obese patients adopt the lifestyle changes necessary for them to lose weight is certainly difficult, but it is not impossible. Primary care physicians are in an excellent position to educate and motivate their patients and they should be aware of the educational and motivational resources available.

    Conflict of Interest:

    Chair of the AIM-HI Advisory

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