Should Doctor's be obligated to talk about nutrition with patients

Scenario: What should a doctor’s role be in promoting healthy eating?

Nutrition is a major factor in an increasingly complex equation that determines overweight and obesity in the United States. Are physicians prepared to help patients improve this aspect of obesity prevention?

Being overweight or obese increases the risk for many chronic health conditions. Even in the absence of excess weight, unhealthy food choices and physical inactivity are associated with major causes of morbidity and mortality, including cardiovascular disease, hypertension, type 2 diabetes, osteoporosis and some types of cancer. The high prevalence of these diseases begs that counseling in nutrition be offered as a part of good medical care. In many cases, such counseling becomes a necessity.

Recently, the Centers for Medicare & Medicaid Services announced that Medicare will pay for obesity counseling if it is coordinated by a primary care physician. CMS determined that “the evidence is adequate to conclude that intensive behavioral therapyfor obesity, defined as a body mass index 30 kg/m2, is reasonable and necessary for the prevention or early detection of illness or disability and is appropriate for individuals entitled to benefits under Part A or enrolled under Part B and is recommended with a grade of A or B by the [U.S. Preventive Services Task Force].”

More people seek medical care services from a primary care physician than from any other source. Hence, the primary care physician should be the one to initiate discussions about nutrition. Perhaps the best time to do it is when explaining the management of the many chronic conditions that diet can affect, such as hypertension, hyperlipidemia and overweight.

Some points that physicians should share with patients:

Being overweight or obese significantly increases health risks, and lasting lifestyle changes are required to protect health. Even small changes, sustained over time, can improve health.

Reducing calorie intake and increasing energy expenditure are essential to losing excess weight or preventing additional weight gain.

A healthy diet can reduce health risks even without weight loss. A healthy diet emphasizes vegetables, fruits, whole grains and low-fat dairy products; includes fish, poultry, beans, nuts and seeds; and limits saturated and trans fats, cholesterol, sodium and sugar-sweetened foods and beverages.