Between 2000 and 2018, the percentage of American adults who are obese increased from 30 percent to over 40 percent. The rate of severely obese individuals doubled within the same period. Obesity is linked with the onset of several chronic conditions, including diabetes and heart disease. Researchers have also noted that people who are obese have a greater chance of developing gastrointestinal problems, such as fatty liver disease, gastric cancer, and chronic acid reflux. In response, the American Gastroenterological Association (AGA) created the Practice guide on Obesity and Weight management, Education, and Resources (POWER), a guide for treating patients with obesity.

1. Dr. Robert Webman

2. Between 2000 and 2018, the percentage of American adults who
are obese increased from 30 percent to over 40 percent. The rate
of severely obese individuals doubled within the same period.
Obesity is linked with the onset of several chronic conditions,
including diabetes and heart disease. Researchers have also noted
that people who are obese have a greater chance of developing
gastrointestinal problems, such as fatty liver disease, gastric
cancer, and chronic acid reflux. In response, the American
Gastroenterological Association (AGA) created the Practice guide
on Obesity and Weight management, Education, and Resources
(POWER), a guide for treating patients with obesity.

3. POWER is a cyclical care protocol that includes prevention,
intervention, and restorative treatments. Most patients enter the
POWER cycle in the assessment phase. At this point, a
multidisciplinary team of physicians would evaluate the patient’s
condition and lifestyle factors that contribute to obesity. The
medical providers may use different tools to assess the patient’s
diet and willingness to follow an obesity treatment plan.
Following the assessment, the patient would enter the weight loss
intervention phase. The treatment plan includes three approaches.
The first is prescribing a calorie-restricted diet. If immediate
weight loss is medically necessary, doctors may recommend a diet
containing fewer than 800 daily calories. This is a short-term diet
that can only be performed under medical supervision.

4. The other components of the weight loss phase include physical
exercise and behavioral health programs. Individuals who are
severely obese can risk injury when beginning a new exercise
plan. After years of following a sedentary lifestyle, the strain of
becoming physically active can also make it difficult for people to
continue their treatment. Behavior programs help patients stay
motivated and follow through with their treatment plans.
If lifestyle changes are not effective, physicians may recommend
second-level therapies for weight loss. The most recognizable
second-level interventions include bariatric surgery and weight
loss medications.

5. The third phase of the POWER cycle focuses on weight loss
maintenance. Keeping weight off is one of the most challenging
aspects of obesity treatment. Regaining weight after rapid loss is
common. Researchers have found that returning to past behaviors
is the most frequent reason people gain weight after dieting.
During the weight maintenance phase, the multidisciplinary team
works closely with the patient to develop a healthy dieting and
exercise plan that fits their lifestyle and expectations. The patient
should be reassessed for health risks towards the end of this
phase. For example, prediabetic patients who undergo obesity
treatment can greatly lower their risk of developing diabetes after
modest weight loss.

6. The final weight gain and regain prevention stage of the cycle may
continue throughout the patient’s life. This phase is also the
beginning point for individuals with a high risk of obesity.
Physicians can provide patient education focused on healthy
lifestyle choices. Patients should schedule regular visits with their
doctor and discuss their weight or health concerns.
The AGA also recommends community-level interventions that
can reduce obesity prevalence. Some examples of these programs
include removing physical and economic barriers to obtaining
fresh produce and designing neighborhoods with safe areas for
physical activity.