In areas where access to specialty care is scarce, a West Virginia University doctor wants to make sure primary care providers have the tools they need to help patients with obesity.
“When I first started my weight management clinic, I had several providers around the state reach out for help,” said Dr. Laura Davisson, chief of obesity medicine at WVU.
Over the summer, Davisson and her colleague Dr. Treah Haggerty decided to launch a statewide needs assessment, which will ask providers, “What are you interested in learning? What topics would you like to know more about? How do you prefer to receive that education?”
Depending on the results, Davisson said she could share insight at annual Continuing Medical Education meetings, immersion courses in Morgantown, e-consultations or webinars. Topics could include anti-obesity medications, bariatric surgery, behavioral change techniques, diet and nutrition, and more.
“Weight loss used to be designated to commercial programs, like stores selling diet products,” Davisson said. “Now, providers are realizing the health care field needs to get involved.”
The assessment is being designed with the help of the Clinical and Translational Science Institute and the Design Studio in the West Virginia Practice-Based Research Network. Davisson estimates the assessment will be ready for distribution by spring. She hopes to have results by summer and to analyze them in the fall. After that, she’ll be working to develop an educational outreach program for the state.
“We know that access to care is an issue in a lot of places, especially in West Virginia and especially in rural areas,” she said. “We wanted to develop a great program here in Morgantown, but that won’t solve the problems in the state if we can’t take our methods and scale them to be disseminated to providers.”
West Virginia practices interested in receiving updates on obesity medicine education may leave their contact information with the WVU Medical Weight Management team at 304-293-1964.
Proper treatment for all aspects
For many people, losing weight is more complicated than diet and exercise alone.
“We have some patients who have underlying psychological issues, such as post- traumatic stress disorder, depression, anxiety or emotional eating issues,” Davisson said.
“For each individual patient, the causes are really, really different. We have to raise awareness of how complicated it is.”
In her practice, Davisson focuses on four main pillars of treatment: food, movement, behavior and medical issues.
Suitable diet and increased physical activity are two important first steps. But then, the focus shifts to behavior tracking. As someone writes down what they eat, or as they track it on an app, they’re more conscious of their actions. And finally, the medical piece of the puzzle is examined — everything from sleep to chronic medications.
“Sometimes there are easy fixes on a medicine list, like one can be substituted for another,” Davisson explained. “The effects might be small, but we don’t need anything to make it harder. It’s already hard enough to lose weight.”
Improving the doctor-patient relationship
Davisson isn’t just working with patients and providers. She’s educating medical students, especially about the importance of relationships.
Despite the American Medical Association’s designation of obesity as a disease in 2013, Davisson says many providers still place blame on patients for their weight.
“It’s a real problem. In my current clinic, we’re very accepting. People open up and tell us about bad experiences they’ve had. It makes them not want to go back to the doctor.”
When patients feel shame, Davisson said they will often disconnect entirely from the health care system, which can lead to even more health problems.
“It starts with the very beginning of the encounter. You want to treat the patient with respect. You teach them to listen to their story, to not interject or judge.”
Part of the curriculum is to expose students to patients in the classroom and in the clinic. Patients share their struggles with the health care system, and their struggles in everyday life. Some students have told Davisson what a lasting impact these stories have had on them.
“I hope it’s going to help them accept obesity as a disease, and I hope it’ll help them relate to these patients in a different way.”