New Obesity Care Algorithm Addresses CVD, Diabetes, and Cancer

Marlene Busko

May 22, 2019

The Obesity Medicine Association (OMA) has released its yearly updated algorithm to help clinicians care for adults with obesity.

The document, first issued in 2013, "aims to provide clinicians [with] an overview of principles important to the care of patients with increased and/or dysfunctional body fat, based upon scientific evidence, supported by medical literature, and derived from the clinical experiences of members of the Obesity Medicine Association," according to the authors.

It summarizes care in a 1-page algorithm and then expands on this in a PowerPoint presentation with more than 500 slides available to the public free of charge, and in an ebook that is free for OMA members and can be purchased by others.

"Understanding the science and clinical management of obesity is integral to addressing the major health epidemics of our time, and the 2019 Adult Obesity Algorithm provides a comprehensive roadmap to do so," Harold Bays, MD, cochair of the document's writing committee and a member of the OMA board of trustees, told Medscape Medical News in an email.

Bays, the medical director of the Louisville Metabolic and Atherosclerosis Research Center (L-MARC) in Kentucky, noted that as a newly added component this year, the algorithm "explores exactly how obesity causes the most common conditions evaluated and treated by clinicians, including cardiovascular disease, [type 2 diabetes], high blood pressure, dyslipidemia, fatty liver, and cancer, and [it] outlines what both patients and clinicians can do to combat this...disease."

However, the authors also caution that the algorithm "is not intended to be a substitute for a medical professional's independent judgment and should not be considered medical advice."

"In areas regarding inconclusive or insufficient scientific evidence, the authors used their professional judgment," they stress.

Obesity Is Much More Than an Increase in Body Fat

In a press release issued by OMA, Bays noted, "Obesity is much more than an increase in body fat. The 2019 OMA Adult Obesity Algorithm helps clinicians combat this expansive disease that affects more than 70% of the population by providing a comprehensive roadmap for treatment and evaluation."

The document delves into the following topics:

  • The chronic disease of obesity

  • Patient assessment and evaluation

  • Nutrition

  • Physical activity

  • Behavior modification therapies

  • Pharmacotherapies

  • Obesity and coexisting diseases

  • Investigational pharmacotherapies

  • Bariatric surgery

It also covers eating disorders such as binge eating disorder (BED), bulimia nervosa, and night-eating syndrome.

And it includes practical patient management tools. For example, in the section on motivational interviewing techniques, it discusses:

  • the 5 A's of Obesity Management: ask, assess, advise, agree, and arrange/assist.

  • OARS: open-ended questions, affirmations, reflections, and summaries.

In the physical activity section, it covers the FITTE exercise prescription: frequency, intensity, time spent, type, and enjoyment level.

The algorithm can be used by clinicians to help them with day-to-day clinical practice, train staff, or prepare for the American Board of Obesity Medicine certification exam.

Bays' L-MARC research site has received research grants from Amarin, Amgen, Alere, Allergan, Arisaph, AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Catabasis, Dr Reddy, Eisai, Elcelyx, Eli Lilly, Esperion, Ferrer/Chiltern, Gemphire, Gilead, GSK, iSpecimen, Janssen, Johnson & Johnson, Kowa, Merck, Necktar, Nichi-Iko, Novartis, NovoNordisk, Pfizer, Regeneron, Sanofi, Selecta, Takeda, and TIMI. Bays has served as a consultant/advisor for Alnylam, Akcea, Amgen, AstraZeneca, Eisai, Eli Lilly, Esperion, Ionis (ISIS), Janssen, Johnson & Johnson, Kowa, Merck, Novartis, Prosciento, Regeneron, and Sanofi; and as a speaker for Amarin, Amgen, Eisai, Kowa, Orexigen, Regeneron, and Sanofi. The disclosures of the other authors are listed with the algorithm.

Adult Obesity Algorithm downloadable slides, ebook: General overview of Obesity Medicine (content omitted in the downloadable slides can be found in the ebook)

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