A multidisciplinary approach to obesity management: the physician's role and team care alternatives

The increasing perception of obesity as a disease is likely to encourage the presumption that obesity ought to be medicalized and managed in the format of a traditional disease model by the existing health care system. Many difficulties will arise from this approach because of factors such as the large numbers of affected patients, the inadequacy of health professionals' training, negative cultural views of obesity, and the inadequacy of financing (ie, health insurance) mechanisms. A series of conflicting expectations related to the services that can be provided by physicians will reinforce their reluctance to manage this disease. Much of the care of obese patients can, however, be provided by a nonphysician primary obesity care provider or team with the physician providing selected support services. Models of a modified team care system, using selected and specific nonphysician personnel and involving the patient in continuing management, may offer some new and effective options for the care of obese patients.