Oct. 16, 2020

Obesity is a life-limiting disorder associated with a number of comorbidities. Currently more than two-thirds of U.S. citizens are overweight (body mass index ≥ 25 kg/m²) and over one-third are obese (BMI ≥ 30 kg/m²).

"If current trends hold", expands Manpreet S. Mundi, M.D., Endocrinology, Diabetes, Metabolism, and Nutrition, at Mayo Clinic in Rochester, Minnesota, "the overall prevalence of obesity in the U.S. is expected to rise to close to 50% by 2030, with 29 states having higher than 50% prevalence." Similar trends are expected worldwide where 500 million adults are obese currently. This number is estimated to increase to 1.12 billion by 2030.

Dr. Mundi notes: "Management of obesity can be challenging. It needs to be considered from many different perspectives, given multifactorial etiology. There is not a one-size-fits-all answer to weight loss, and maintenance often requires ongoing care. Additionally, with expected rise in prevalence over the next decade, many current models are unsustainable, requiring us to continue to evolve and adapt to meet the needs of this ever-growing population.

"In considering these factors, the advanced weight management program team evaluated the current state of obesity practice and noted that extensive resources were expended on patients with low or minimal motivation or comorbidities. Due to this factor, we decided to expand the program to begin prior to the patient arriving in Rochester."

In December 2018, a nurse triage phone call was implemented to assist program providers to better serve individual patients once they arrive on campus. "This triage call provides a foundation of medical history and understanding of patient needs, as well as concerns related to obesity," says Dr. Mundi. Information gathered in the phone call is reviewed by one of the program's nurse practitioners to determine the patient's candidacy, as well as which pathway the patient should be started on when arriving on campus. The advanced weight management program currently offers four pathways to weight loss: lifestyle, weight-loss medication, endoscopic procedures and bariatric surgery.

Julia A. Jurgensen, APRN, C.N.P., D.N.P., Endocrinology, Diabetes, Metabolism, and Nutrition, at Mayo Clinic in Rochester, Minnesota, adds, "The weight management nurses have developed an excellent approach to these phone calls that allows me and colleagues to best understand the needs of the patient prior to the patient's arrival on campus."

Patients are also directed to review the Weight Management page on Mayo Clinic Connect prior to their visit to learn more about each of the weight-loss pathways offered. The page is updated several times each month by Mayo Clinic weight management experts offering advice and discussion about the most recent developments in weight-loss options. The page allows patients to remain engaged by reviewing the weight-loss options in depth before their initial visit.

"Once the patient arrives on campus, our goal is meet their needs efficiently, through a tailored itinerary with a team-based approach involving physicians, psychologists, nurse practitioners, physician assistants, nurses and dietitians with expertise in obesity management," says Dr. Mundi. "Depending on the patient's needs and pathway choice, additional visits may be necessary. Video technology has allowed some of these visits to be conducted from the patient's home."

Jurgensen notes: "The feedback has been overwhelmingly positive for these additional video visits, as they allow patients from around the country to follow up with the medical team after weight-loss procedures. That follow-up is critical to their success."

For more information

Mayo Clinic Connect. Weight Management. Mayo Clinic.