Obesity in Primary Care: A Comprehensive Approach for Family Physicians

Abstract

Obesity is a disease driven by the interplay of varied factors such as genetic, environmental, and behavioral factors. It can pose a risk for numerous comorbidities, including type 2 diabetes, cardiovascular disease, obstructive sleep apnea, and cancer. Despite its prevalence and health consequences, obesity remains substantially undertreated in primary care. This review highlights the current understanding of obesity pathophysiology, classification, and epidemiology, with an emphasis on clinical management in the primary care setting. Evidence-based strategies for prevention, screening, and treatment, including lifestyle interventions, behavioral counseling, pharmacotherapy, and surgical options, are being presented. Obesity management requires a patient-centered, multidisciplinary approach. Primary care providers play a pivotal role in initiating care through routine assessment (body mass index (BMI), waist circumference, and neck circumference), addressing different challenges, and delivering counseling with the help of motivational interviewing. Primary care is a critical frontline setting for obesity prevention and treatment. Enhancing provider education, adopting structured counseling models (e.g., 5As: assess, advise, agree, assist, and arrange), leveraging telehealth, and expanding access to multidisciplinary teams can improve outcomes. Addressing obesity proactively and comprehensively in primary care, along with shared decision-making (SDM) where patients and physicians can mutually create a treatment plan, can reduce the burden of chronic disease and improve population health.