Improving Obesity Management Training in Family Medicine: Multi-methods evaluation of the 5AsT-MD Pilot Course
the United States Preventive Services Task Force and the Canadian Task Force on Preventive Health Care recommends that primary care practitioners screen patients, counsel regarding weight loss, and refer to structured behavioural interventions aimed at weight loss.(3,4) However, addressing obesity in a clinical consultation can be challenging for both physician and patients. In fact, many physicians are not routinely discussing weight and report a lack of confidence in obesity management
... y management skills, lack of time, and fear of endangering their relationship to patients by discussing weight.(5-11) Predominant societal negative attitudes towards persons living with obesity also affect care and further complicate clinical conversations.(12,13) As a result, patients often feel uncomfortable bringing up weight concerns despite expressing their need for physicians to initiate such a conversation. (14-17) One of the challenges for effective obesity counselling is that medical residents and students do not receive sufficient training on the complex physiology of obesity and evidence-based management strategies, and these topics are not well covered in medical exams.(18-22) A recent review concluded that across the world there is a paucity of obesity education programs for learners in health professions.(23) Reasons include the relative newness of classifying obesity as a disease, the complexity of causation and management, and the socio-cultural and personal associations that physicians, residents, medical educators, and patients bring to each interaction that addresses obesity.(24-28) The result is a substantial lack of capacity in primary health care to deliver comprehensive, tailored, and effective obesity prevention and management.(29-32) Despite calls from international health and professional organizations to improve curriculum and training in obesity and evidence that high-quality education programs can improve outcomes (23), progress has been slow and no widely recognized courses have been implemented to date. (31, (33) (34) (35) It is essential that family medicine residents are prepared to: 1) identify complex causes of obesity and its associations with comorbidities and mental health, 2) counsel on appropriate weight management options, and 3) navigate interdisciplinary teams and resources to best assist the patient. There is a pressing need to create high quality, evidence-based obesity management training courses for family medicine residents so they can deliver quality patient care.