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Finally, Doctors are learning to address Obesity
Obesity plays such a big role in illnesses like diabetes, high blood pressure and heart disease,” she says. “It affects your quality of life and your self-esteem. And it may take losing only five to 10 percent of your weight to regain your health and your confidence.”
These days, Clark, a senior clinical fellow in the Division of General Internal Medicine, is the one teaching residents how to deal with overweight patients. Following the six-step method she learned in the Faculty Development Program—identifying and assessing needs, setting goals, developing content, implementing and evaluating–she teamed up with fellow participants Susan Bartlett, a behavioral scientist, and Deborah Young, a researcher with interests in exercise and physical fitness, and designed a curriculum based on the 1998 NIH guidelines for managing obesity. The trio piloted their curriculum at Bayview during the one-month med-psych internship rotation. For the first time interns practiced skills for obesity counseling, setting weight goals and writing diet and exercise prescriptions. Meanwhile, the entire house staff was treated with a noon lecture on managing obesity. Aids like BMI (body mass index) tables and community resources became standard postings in the house staff clinic. Now, Clark’s received a $50,000 two-year grant from Weight Watchers, presented personally by Sarah Duchess of York (see page 5) that will pay for a teaching video, standardized patients and small group sessions. What’s more, Clark’s brainchild is about to expand to the Johns Hopkins Hospital, where it will become a standard part of the curriculum for internal medicine residents. For the Faculty Development Program there is no finer tribute.
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When Jeanne Clark was doing her internal medicine residency at Dartmouth, she was aghast at the numbers of patients she met—some as young as their teens and 20s—whose medical problems were linked to gross overweight that no one was addressing. Doctors told patients to reduce, but without specific recommendations. There were no community programs, no exercise prescriptions, no realistic weight goals. Why, wondered Clark, was something so important so overlooked in training primary care physicians?"
