Exercise management of obesity.
When dealing with overweight patients, it is important to treat obesity as a chronic condition requiring long-term management. Physicians do not send a patient with hypertension home with just one bottle of pills and expect blood pressure to be managed forever. Similarly, it is naive to think that sending an overweight patient home with only a single word of advice to "lose weight" will solve the problem. Medical staff would be wise to adopt the attitude that obesity requires long-term intervention and management, just as hypertension requires ongoing monitoring and management. Continued attention to patients' physical activity is required. It is important for physicians to spend a few minutes discussing physical activity with their patients. The patient's current and past levels of physical activity should be assessed as well as the barriers to and benefits of activity. Normal-weight patients should accumulate at least 30 minutes of moderate-intensity activity on most days of the week, and overweight patients should accumulate 60 to 80 minutes per day, every day. The physician can provide some simple tools, such as a step counter and self-monitoring forms, to promote increases in activity and can follow up with the patient after the office visit. This information may sound like a lot to cover, especially given the limited time available for each patient. By spending 3 to 5 minutes intervening, however, physicians can play a critical role in promoting health. Physicians should set a goal to address one specific topic (e.g., a brief discussion of exercise benefits and barriers) and try one strategy (e.g., introduce self-monitoring) during the next counseling session with patients. It is also important for physicians to remember that their success in changing behavior may be in small increments. These small changes can and do eventually lead to success for many patients and physicians.