RS9775 timothy garvey 2008 1 scrW. Timothy Garvey, MD, FACEUnder the leadership of W. Timothy Garvey, MD, FACE, chair of the UAB School of Health Professions Department of Nutrition Sciences, the American Association of Clinical Endocrinologists unveils new guidelines for obesity management. Released by the Obesity Scientific Committee, chaired by Garvey, the clinical practice guidelines emphasize a patient-centric approach that individualizes treatment with a focus on overall health rather than just weight loss.

“We need to present our patients with a healthy meal plan that is consistent with their cultural and personal preferences,” said Garvey in an interview with Endocrine Today. “This could be a Mediterranean diet, a DASH diet, a low-carb diet, a low fat diet, a vegetarian diet – just something that a patient will adhere too in a reduced calorie format.”

The evidence-based guidelines include “screening, diagnosis, staging, thereapeutic decisions, endpoints and goals of therapy related to obesity management.” They focus on when to use different treatment modalities and the level of intensity of those modalities based on an obesity algorithm for care designed around the stage of disease. As an example, Stage 0 may only require lifestyle intervention while Stage 3 could call for surgery.

WATCH VIDEO: Garvey offers tips for helping patients lose weight

Garvey pointed out that the three phases of chronic disease 1) preventing disease 2) preventing disease progression and 3) treating disease complications were used as the basis for the updated guidelines. He also added that each phase should inform the evaluation of patients and the management of obesity.

“At UAB Weight Loss Management we screen our patients for binge-eating syndrome because this is more common in patients that are obese than meets the eye,” said Garvey. “The important thing here, is that this is when we bring in our clinical psychologist to the treatment plan. If you don’t deal with the psychological issues up front then your lifestyle intervention will probably not work as well.”

READ MORE: AACE/ACE New Clinical Practice Guidelines

The new practice guidelines also include working with the five FDA-approved weight-loss medications. This includes dosing, adverse effects and contraindications.

“There is a dose-response between the amount of weight loss you need and the clinical improvement for different complications,” said Garvey at a news conference. “We reviewed the evidence and established that relationship and what therapeutic success looks like, specific to each of these weight-related complications.”

At the news conference, Garvey also talked about stereotypes and common misperceptions. He reminded physicians that not all obese or overweight patients are the same. He explained that in regard to metabolic profile, patients can be metabolically healthy yet suffer from obesity. Garvey said these patients are not at elevated risk for diabetes or heart disease and generally do not develop metabolic syndrome or prediabetes and therefore should not be treated with intensive therapies that pose more risk than benefit.