“Obesity is a national epidemic and soon may bypass smoking as leading risk factor for heart disease,” notes Jill Grimes, MD, an authority on preventitive medicine and patient education. But what is the physician to do to help overweight and obese patients? To help answer that question, she made a presentation, “Obesity: Quick and Easy Tools to Help Your Patients Lose Weight and Exercise,” at the 2010 Scientific Assembly of the American Academy of Family Physicians in Denver. Her advice is, to begin, find out what they have been eating lately. “They taught this in residency, but I haven’t heard a word about it since.” That is “24,” in other words, “Tell me everything you ate and drank since yesterday, starting with breakfast.” Inevitably, she says, the reaction is “Oh no, not yesterday!” It was a holiday, the children had a party, there was a can’t-miss work lunch. For some reason, the patient had to go to McDonald’s. “You should write it down,” she says: fruit and vegetable servings, restaurant meals, skipped meals, fast food, and snacks. What comes next? “There’s a nemonic I use when talking to patients: MORE.”
Talking to your patient about their obesity takes only two or three minutes of a typical office visit and can do a disproportionate amount of good, she says. Further, you should have them schedule a followup appointment for a month later. That will motivate them to stick to it.
- More fruits and vegetables. “No one is overweight from eating too many fruits or vegetables.” There should be five servings of fruits and vegetable servings every day? What’s a serving? “A handful,” she says.
- Organize the snacks. “Stock the pantry with healthy things that you can make into grab-and-go portions. For example, apple or orange slices. “Or you can buy single serving snacks like they have at the market -- fresh fruit cups, things like that. Always bring your own snacks.”
- Ramp up the fiber. The goal is more than 25 grams per day. Fiber is filling (it has a high volume and low calories).
- Exercise daily. According to Dr. Grimes, “Daily exercise improves mood and creates a habit. Tell them to keep a record. Cross train. Take the dog for long walks. You’ll be your dog’s best friend.”