#24 Curbside Round Table: Pondering Obesity

January 30, 2017 | By Matthew Watto, MD

More tools, tips, and tricks so you can master obesity in clinic. On this first roundtable episode, The Curbsiders give their take on the management of obesity, and offer their own practice changing tips. Also, Paul announces his goal to watch 365 movies in 365 days, and the guys give more great book, movie, and TV recommendations.

Got feedback? Email thecurbsiders@gmail.com  

Picks of the week

1. Matt’s pick – Never Eat Alone by Keith Ferrazzi
2. Paul’s pick – Sing Street (film)
3. Stuart’s pick – Lemony Snicket’s: A series of unfortunate events

Clinical pearls (from Recap and response OR Brief topic review)

1. Obesity is a DISEASE. Not a lifestyle choice.
2. Percent weight loss by intervention
   • Diet and lifestyle 5-10%
   • Medications >10%
   • Bariatric surgery >30%
3. Utilize specialist referral to gain resources e.g. dietician, and psychologist through bariatric surgery referral
4. Put faith in your patients ability to change and they will hold themselves accountable

Coding tips

1. If BMI >35 then code “morbid obesity” to increase medical decision making
2. Code “BMI” in addition “Morbid obesity”
3. Be sure to code comorbid conditions e.g. hypertension, diabetes, hyperlipidemia, OSA

Time Stamps

00:00 Intro

01:29 Picks of the week

06:07 Recap and responses to our obesity interview with Dr. Garvey

08:55 Mechanisms of obesity

10:15 Discussion of relapse rates, weight gain

11:23 Percent weight loss per therapy

14:35 Treating obesity on a budget

18:51 Coding tips

20:43 Diet, lifestyle counseling and how to leverage resources

26:38 Closing remarks

28:40 Outro

Disclosures:

The Curbsiders report no relevant financial disclosures, but as always hope to have lots of them in the future.

Links from the show:

1. Tomlinson, S et al. Mechanisms, Pathophysiology, and Management of Obesity. NEJM 2016; 376(3) http://www.nejm.org/doi/full/10.1056/NEJMra1514009
2. E&M University website http://emuniversity.com
3. ICD10Data.com http://www.icd10data.com
4. Matt’s pick – Never Eat Alone by Keith Ferrazzi
5. Paul’s pick – Sing Street (film)
6. Stuart’s pick – Lemony Snicket’s: A series of unfortunate events

Tags: care, doctor, family, health, hospitalist, hospital, internal, internist, medicine, medical, obesity, primary, physician, student, resident

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