J Korean Med Assoc.  2024 Apr;67(4):240-255. 10.5124/jkma.2024.67.4.240.

Guidelines for obesity clinic consultations in primary healthcare clinics

• Kang JH
• Kim KK

• KMID: 2554178
• DOI: http://doi.org/10.5124/jkma.2024.67.4.240

Abstract

Background
The prevalence of obesity and its public health implications underscore the necessity for prioritizing its prevention and care in primary healthcare clinics.
Current Concepts
The establishment of dedicated obesity clinics requires a comprehensive initial assessment of patients, ideally facilitated by a pre-consultation questionnaire. The initial assessment of patients includes a detailed patient interview, thorough physical examination, body composition analysis, and evaluation of visceral adiposity. Identifying potential causes of secondary obesity, particularly drug-induced obesity, is imperative before the initiation of treatment. The primary goal of obesity management transcends weight reduction alone and should encompass the improvement of overall health status, addressing concurrent comorbidities. Individualized treatment goals are established after a thorough assessment. Although the cornerstone of obesity management is the promotion of a healthier lifestyle, personalized approaches tailored to the circumstances of each patient are advocated for long term sustainability. Dietary and exercise recommendations should be personalized and introduced progressively. Pharmacotherapy can significantly potentiate lifestyle modification efforts for weight reduction. However, the selection of pharmacological agents must be reasonable, considering factors as comorbid conditions, severity of obesity, previous weight gain history, and economic constraints related to treatment. Dosing regimens should be meticulously calibrated and adjusted as necessary, with vigilant monitoring of the therapeutic efficacy and potential adverse reactions.
Discussion and Conclusion
Effective obesity management in primary healthcare clinics involves thorough assessment, goal setting, recommendation of individualized lifestyle modifications, and careful implementation of suitable pharmacotherapy.

Keyword

Primary health care; Diet therapy; Exercise; Anti-obesity agents; 일차의료; 식사치료; 운동; 비만치료제