Rethinking obesity care in the United States: Lessons from the cardiovascular disease – Cardiac rehabilitation model

Abstract

The prevalence of obesity in the United States (U.S.), in conjunction with the myriad of detrimental health consequences associated with this disease, justifiably warrants deep concern and characterization as a national health crisis of epidemic proportions. The healthcare journey of patients suffering from and seeking treatment for obesity is, in many ways, more complex than other conditions - weight sigma, leads to negative attitudes, stereotypes, prejudice, and discrimination. A patient seeking care for obesity is often faced with having to prove their condition is not the cause of a behavioral abnormality and that their current state can be modified by lifestyle modifications, such as diet and exercise. At the same time, the infrastructure and reimbursement for lifestyle management is woefully insufficient in the current U.S. healthcare system, a system built upon disease management through pharmacotherapy and surgical options. Obesity care is evolving rapidly, and a treatment paradigm shift is needed. The magnitude and severity of the obesity epidemic demands it. Any alternative care model to be proposed should be readily scalable, sustainable, and have a strong, established, scientific foundation. Herein, we propose adopting and adapting the CVD care approach to patients diagnosed with obesity.