Patient Tools

Assist: Applying the Fourth of the 5As to Treat Obesity in Primary Care

by Thomas McKnight, MD Patient Tools

Assist: The proposed CMS decision to pay for behavioral counseling for weight control in the primary care setting, describes ‘Assist’ as a session where the provider uses “behavior change techniques [to] aid the patient in achieving agreed-upon goals by acquiring the skills, confidence, and social/environmental supports for behavior change.” We, primary care physicians, need to [...]

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How might a physician begin to discuss a child’s obesity with the parents?

by Thomas McKnight, MD Patient Tools

In the drawer next to my exam room computer are the CDC BMI charts filed by pre-adolescent (2-12), adolescent (13-18), and boy/girl. On the CDC chart, my medical assistant circles the child’s BMI and leaves the chart by the computer. At the end of the appointment I hand the chart to the parent. I show, [...]

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Encourage the combination of weight management and the DASH diet, over medications, with patients who are both hypertensive and obese

by Thomas McKnight, MD Patient Tools

Tom’s comment: The added effect of weight loss and the DASH diet in lowering blood pressure is greater than the DASH alone. This is important. By itself according to JNC VII, the DASH diet is equal to mono-pharmaceutical therapy. When talking to patients, about the ‘why’ of weight loss, I focus on body-healthy over the [...]

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Financial Incentives do work for weight loss…but it may not last into weight maintenance

by Thomas McKnight, MD Patient Tools

Financial incentives for extended weight loss: a randomized, controlled trial. J Gen Intern Med, 2011 Jun;26(6): 621-6. http://www.ncbi.nlm.nih.gov/pubmed/21249462  All participants underwent a 24-week weight loss program with the goal of 1 lb weight loss per week. The 8-month maintenance phase was divided into 3 groups, one with dietary advice and monthly weigh-ins as the conventional [...]

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Calorie Count Low in 40% of Menu Items; In 19%, Way Low

by Thomas McKnight, MD Patient Tools

Stated Calorie on Menus of Certain Restaurants Appear to be Accurate Overall – JAMA, July 19th 2011 The 2010 healthcare law requires restaurants with more than 20 locations to list the caloric density of their foods. The Jean Mayer USDA Human Nutrition Research Center on Aging reported studying 269 food items to determine if the [...]

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