RobardUser Robard Corporation | All posts tagged 'type 2 diabetes'

The Other Obesity-Related Disorder Physicians Should Be Talking About – And It’s Not Diabetes… (Free White Paper)




Overweight and obesity have long been associated with over 30 different chronic comorbid conditions. But some of these conditions are more readily talked about with providers than others. The impact of weight on Type 2 Diabetes, Heart Disease, and Hypertension is pretty clear to both patients and physicians alike. 

But did you know that Nonalcoholic Fatty Liver Disease affects one-third of American adults and is expected to be the most common reason for liver transplantation?

Fatty liver occurs when too much fat is stored in the liver cells. Over time, this extra fat can lead to inflammation and scarring, or nonalcoholic steatohepatitis (NASH), and putting the patient at highest risk for liver cirrhosis necessitating liver transplant.

The insidious thing about fatty liver is that it generally does not present any symptoms, so it is a condition that can go undiagnosed.  However, it is most often suspected when the liver enzymes are elevated on routine blood testing, but is generally definitely confirmed through liver biopsy.

What causes fatty liver isn’t definitely known, but is clearly associated with being overweight or obese. According to the Mayo Clinic, NAFLD affects an estimated 80 million to 100 million Americans, and 90 percent of the patients diagnosed with NASH (and are at high risk for cirrhosis) are either overweight or obese.

Because of the asymptomatic nature of fatty liver disease, physicians may be unknowingly taking preemptive measures to diagnose the disorder when they choose to address their patients’ weight through a medically supervised weight loss program. Robard’s program, for example, involves physician-reviewed medical protocols that require the patient to undergo ongoing medical supervision and blood work that can be helpful in identifying underlying conditions such as fatty liver. And even more good news – one of the most effective and least invasive methods of treating the disease has been found to be weight loss. So participation in a weight management program can help physicians simultaneously diagnose AND treat the disease. How’s that for efficiency?

According to the Centers for Disease Control and Prevention, the number of deaths from chronic liver disease and cirrhosis has risen every year since 2007, and with obesity also on the rise, we can count on those deaths to steadily increase -- unless physicians take a proactive approach.

"Weight loss works, whether through a bariatric procedure or a strict dietary approach," says Dr. Jay Horton, director, Center for Human Nutrition at UT Southwestern Medical Center. "Even an eight percent to 10 percent weight loss seems to improve liver fat.”

If you are interested in learning more about fatty liver and the most efficient way to diagnose and treat it, download our free white paper, Liver Enzyme Abnormalities, by Dr. John D. Hernried of The Hernried Center for Medical Weight Loss. Then contact us to find out more about how we can help you get a program started that can help you provide the solutions your patients need to live healthier lives!

Sources: US News, CNBC

Blog written by Vanessa Ramalho/Robard Corporation


Read More >>

Obesity — A Term that Carries a Lot of Weight. Should We Change It?



The idea of obesity is a difficult subject to broach on many levels. The term itself is loaded with stigma, and people who suffer from this condition can become resistant to even hearing the word, let alone talk about it. The shame and anticipation of judgement can be disabling, and yet the language we use when discussing weight is so limited. What can health practitioners do to break down the wall?

In a study published in a 2012 issue of the journal Obesity, researchers asked 390 obese adults in primary care settings in the Philadelphia area to complete a questionnaire about the terms that are most and least acceptable to describe excess body weight. Out of the 11 terms that were offered, “fatness” was rated as the most undesirable, followed by “excess fat,” “large size,” “obesity” and “heaviness.” (The most preferred terms were simply “weight,” “BMI,” “weight problem” or “excess weight.”)

These words encompass the majority of terminology currently used in health care to describe excess weight. But in an effort to change how physicians and patients engage with the topic of obesity, the American Association of Clinical Endocrinologists, or AACE, and the American College of Endocrinology, or ACE, have proposed a new diagnostic term to describe obesity: Adiposity-Based Chronic Disease, also known as ABCD.

“Right now, obesity is relegated to a simple construct of having a [body mass index] over 30,” says co-author Dr. Jeffrey Mechanick, a professor of medicine and medical director of the Kravis Center for Cardiovascular Health at the Icahn School of Medicine at Mount Sinai in New York City and past president of AACE. “But the word obesity doesn’t confer sufficient information about the disease risks.” ABCD on the other hand, focuses on a complications-centric approach to diagnosing, categorizing, and treating overweight.

The categorization takes into account a number of measures. In addition to BMI, this new system also takes into account the person’s waist circumference, waist-to-hip ratio, fat identified on advanced body imaging techniques such as ultrasound and MRI, and perhaps inflammatory markers on blood tests. The proposed model also includes three distinct stages:

Stage 0: The person is carrying excess weight but doesn’t have health complications from it.

Stage 1: The person is experiencing mild to moderate complications — such as prediabetes or slightly elevated blood pressure — due to excess body weight.

Stage 2: The person has more severe complications – such as type 2 diabetes or significantly high blood pressure – that are related to carrying excess weight.

What category a patient falls into would inform treatment, and would also increase the likelihood that a physician would focus on treating not just weight related complications, but also the excess body weight itself.

This new model will hopefully not only create a less biased way for physicians to engage with patients about their weight; it will also hopefully be a way for weight loss treatments to be more readily covered through insurance by having this new diagnostic term being incorporated into the medical coding structure — such as the ICD-10, or the International Classification of Diseases.

How we talk about obesity matters. And perhaps a better way to talk about obesity is to not talk about “obesity.” Not in the way people are used to hearing anyway. What are your thoughts?

Source: U.S. News


Blog written by Vanessa Ramalho/Robard Corporation


Read More >>

You Can’t Afford to Ignore Obesity: How Obesity Treatment Saves Time, Money and Lives



Why should a busy healthcare provider take time out of their day to treat obesity when their patients are dealing with so many other health issues? This seems to be the prevailing question among many providers, despite obesity’s 2013 designation as a disease. There are so many other diseases and ailments that need to be treated, so why obesity?

The answer: Because we can’t afford not to! And that applies to time, money and the health of your patients.

It’s true that chronic diseases suck up the majority of healthcare resources; 75 percent of all health care costs are linked to chronic conditions. People with chronic conditions are the most frequent users of health care in the U.S., and they account for 81 percent of hospital admissions; 91 percent of all prescriptions filled; and 76 percent of all physician visits. Chronic disease is widespread, and it’s only getting worse. By 2025, chronic diseases will affect an estimated 164 million Americans — nearly half (49 percent) of the population

In response to the growing concern over chronic disease, many healthcare providers and hospitals are investing thousands of dollars in resources and time to implement multi-level treatment plans targeting chronic conditions. But the question many advocates are forgetting to ask is: What is one of the most common links between many chronic conditions?

The answer: OBESITY.

Obesity is associated with significantly increased risk of more than 20 chronic diseases and health conditions that cause devastating consequences and increased mortality. Consider the following statistics:

• In the often-cited Framingham Offspring Study, obesity was responsible for 78 percent of cases of hypertension in men and 64 percent in women
• The well-known Nurses’ Health Study of more than 44,000 women found high waist circumference resulted in a two-fold increase in coronary heart disease
More than 85 percent of people who have type 2 diabetes are overweight, and more than 50 percent are obese
• Overweight and obesity are associated with increased mortality from diabetes and kidney disease, resulting in over 60,000 excess deaths per year

And this is just the tip of the iceberg. Obesity, in many cases, is the direct cause of many of the chronic conditions that we are spending so much time and money treating. Many of these conditions can be prevented, delayed, or alleviated by simply treating the cause, not just the symptoms. Research shows that modest weight loss (five to 10 percent of body weight) can reduce the risk of developing chronic conditions dramatically, and this amount of weight loss is achievable through various evidence-based medical obesity treatment models.

Not only can obesity treatment save physicians time and money by decreasing healthcare costs associated with comorbid chronic conditions, it has also been shown to be a proven revenue generating model, with real financial benefits. In a climate when we’re unsure about where we will stand with insurance and Medicare, it is imperative for healthcare providers to proactively look for new and innovative models to save time and money, and ultimately, to save lives.

Are you still asking yourself, “Why treat obesity?”


Sources: Partnership to Fight Chronic Disease, Hospitals & Health Networks, Stop Obesity Alliance

Blog written by Vanessa Ramalho/Robard Corporation


Read More >>