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Clinical Research

The essential role of primary care providers in obesity management

International Journal of Obesity volume 47, pages 249–250 (2023)Cite this article

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In response to US Preventive Services Task Force recommendations [1], the Centers for Medicare and Medicaid Services approved intensive behavioral counseling delivered by primary care providers (PCPs; physicians, nurse practitioners, or physician assistants) to address obesity [2]. These federal mandates emphasize the critical role of primary care clinic teams in obesity management. Indeed, obesity is not a disease that should be treated solely by specialists; engaging primary health care systems is imperative for widespread access to treatment. According to recent prevalence estimates, 74% or approximately 185 million individuals in the United States (US) have overweight or obesity [3], and thus qualify for weight management based on their body mass index (BMI). Yet there are fewer than 8000 obesity specialists, but about 639,000 PCPs available to address this persistent challenge to population health.

A key question, however, is whether PCPs are well equipped to provide obesity management care. The ACTION studies, multinational internet-based surveys of patients, providers, and employers, revealed numerous barriers to effective obesity management [4]. In our work with PCPs, the primary barriers to clinical management of obesity were lack of (1) practical training for PCPs and primary care team members, (2) nutrition support for patients, (3) behavioral strategies and psychological support for patients, and (4) obesity care coverage (reimbursement for PCP time and coverage for anti-obesity medications). Furthermore, our research revealed that interventions to address these first three barriers need to be scalable, time efficient, and cost-effective to be useful in primary care, especially in communities where the population is at highest risk for obesity and related chronic disease. We describe each of these barriers here and emphasize the importance of the development of interventions (tools and strategies) that will support obesity management in primary care.

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Author information

Authors and Affiliations

  1. Center for Community Health Impact and Department of Health Promotion & Behavioral Sciences, The University of Texas Health Science Center at Houston, School of Public Health El Paso, El Paso, TX, USA

    Leah D. Whigham

  2. Department of Epidemiology, Human Genetics & Environmental Sciences, The University of Texas Health Science Center at Houston, School of Public Health Dallas, Dallas, TX, USA

    Sarah E. Messiah & Bijal A. Balasubramanian

  3. Center for Pediatric Population Health, The University of Texas Health Science Center at Houston, School of Public Health, Dallas, TX, USA

    Sarah E. Messiah

  4. UTHealth Houston Institute for Implementation Science, The University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, USA

    Bijal A. Balasubramanian

  5. Department of Nutritional Sciences, Texas Tech University, Lubbock, TX, USA

    Nikhil V. Dhurandhar

Authors
  1. Leah D. Whigham
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  2. Sarah E. Messiah
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  3. Bijal A. Balasubramanian
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  4. Nikhil V. Dhurandhar
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All authors contributed to the writing and approved the final version of the article.

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Correspondence to Leah D. Whigham or Nikhil V. Dhurandhar.

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The authors declare no competing interests related to this article. LDW and NVD developed the concept and initial draft of the article.

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Whigham, L.D., Messiah, S.E., Balasubramanian, B.A. et al. The essential role of primary care providers in obesity management. Int J Obes 47, 249–250 (2023). https://doi.org/10.1038/s41366-023-01268-7

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