WASHINGTON — When assessing patients with refractory obesity, it's useful to consider separately each of the factors that influence obesity, Dr. Arya M. Sharma said at the annual meeting of the Obesity Society.
Lifestyle changes are important in maintaining long-term weight loss, whether the initial weight loss was achieved by diet, exercise, pharmacotherapy, surgery, or a combination of methods, noted Dr. Sharma, a professor of medicine and research chair for obesity research and management at the University of Alberta in Edmonton (Canada). As part of long-term obesity management, he said, it's important to address the “Four Ms”:
▸ Mental health. Disorders that may influence obesity treatment include mood, anxiety, sleep, addiction, psychotic, and cognitive disorders.
▸ Mechanical problems. Obese patients may face a variety of mechanical difficulties, including osteoarthritis, obstructive sleep apnea, urinary incontinence, and plantar fasciitis. Addressing such problems can help patients maintain an exercise regimen and sleep better.
▸ Medical disorders. Treatment of conditions such as hypertension or diabetes can affect how well patients follow an obesity treatment plan.
▸ Money issues. Obesity-related monetary issues include expenses for oversized clothes and furniture. A low income might limit access to healthy food, or financial stress might trigger overeating.
Disclosures: Dr. Sharma has received grants from and been an adviser or consultant to several companies.