Biotech Week
© Copyright 2003, Biotech Week via NewsRx.com
2003 JAN 22 - (NewsRx.com & NewsRx.net)
-- As obesity reaches epidemic proportions, Kaiser Permanente's
Care Management Institute (CMI), the U.S. Centers for Disease
Control and Prevention (CDC) and others have joined forces
to find effective ways to prevent and treat it.
"With 30% of the population having a body mass index (BMI)
of 30 or more and 15% of children and adolescents at or
above the 95th percentile for weight, the effective treatment
of obesity is a public health issue. It's essential that
the CDC has partners to help push this treatment agenda
forward," said William Dietz, MD, PhD, the CDC's director
of the Division of Nutrition and Physical Activity, National
Center for Chronic Disease Prevention and Health Promotion.
"Kaiser Permanente, with nearly 9 million members, is an
important partner for us. That's the level of interest we
need, and it's a real tribute to Kaiser that they've embarked
on this effort," says Dietz.
The KP/CDC collaboration has focused on identifying effective
interventions to prevent and treat obesity that can be implemented
rapidly and broadly throughout Kaiser Permanente and elsewhere.
The forum links practicing clinicians with leading national
experts from academia, medicine, healthcare delivery systems,
research, and the federal government.
"We bring together caregivers and their colleagues who
are engaged in research so that we can more rapidly translate
lessons from science and experience into applications that
will make a difference," says William Caplan, MD, director
of clinical development for Kaiser Permanente's CMI. "In
short, we're asking ourselves, what do we know enough about
now to bring forward into action?" said Caplan.
Two working meetings brought together Kaiser Permanente
clinicians and experts from around the country. Within the
larger working group, four subgroups focused on:
Subgroups identified effective interventions that could
be implemented. Each subgroup included representatives from
all Kaiser Permanente Regions who bring the recommendations
back to their home territory for implementation. In this
way, the interventions sponsored by the working group can
be put into action in ways that are both uniform program
wide and sensitive to local variations in practice and resources.
Members of the working group looked at a number of issues
during the course of the two meetings, including counseling
overweight and obese patients, nutritional and physical
activity messages, culturally competent care, and the roles
of behavioral modification, pharmacotherapy, and bariatric
surgery in treating obesity.
Other presenters took a broader view, addressing school-
and community-based weight management interventions, weight
management in the work site, and state level initiatives.
The subgroups developed several approaches for immediate
implementation within Kaiser Permanente, including:
Presurgery and post-surgery protocols for severely obese
patients were assessed, and nonsurgical interventions also
were developed.
A nutritional message for adults also focuses on the energy
density of foods. Barbara Rolls, PhD, Gutherie Chair of
Nutrition, Pennsylvania State University, discussed the
concept of "volumetrics," in which the key concept is the
relative caloric density of foods, rather than macronutrient
(fat, carbohydrate, protein) content. Rolls' research shows
that the energy density - not the fat content - of a diet
affects energy intake. To that end, she recommends modifying
portion size according to the energy density of foods.
Cultural competence in delivering care for overweight and
obese individuals is also emphasized. Njeri Karanja, PhD,
of Kaiser Permanente's Center for Health Research, focuses
on morbidity/mortality data, salient demographics and economic
characteristics, and the cultural and psychosocial experience
of African Americans, as well as recommendations for intervening
effectively to prevent and treat obesity in this population.
Addressing culturally competent care with Mexican Americans,
John Foreyt, PhD, Baylor College of Medicine, notes that
culturally competent weight management programs require
a behavioral analysis of factors and barriers affecting
weight.
This article was prepared by Biotech Week editors from
staff and other reports.
