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Telemedicine can mitigate barriers for access to obesity care, weight loss management

According to a research published online in Obesity, The Obesity Society’s flagship magazine, telemedicine presents new prospects to lower obstacles to obesity care faced by healthcare providers, patients, and health plans.

‚ÄúTelemedicine and remote healthcare are becoming more widely recognised by healthcare providers and policymakers,” said Scott Kahan, MD, MPH, FTOS, director of the National Center for Weight and Wellness in Washington, DC, and instructor at the Johns Hopkins Bloomberg School of Public Health in Baltimore, Md. “The use of telemedicine for the management of chronic conditions, such as obesity, is critical to ensuring access to high-quality healthcare, particularly for people with limited mobility, those who are underinsured or uninsured, and those who live in places with few healthcare alternatives.” The paper’s first author, Kahan, is also the paper’s lead author.

Nearly 80% of persons in the United States will be pre-obese or obese by 2030, according to estimates. According to the study’s authors, despite the continuous rise in obesity incidence and the difficulties many patients have in losing and maintaining weight, guideline-supported treatments such as medication, intensive behavioural therapy, and bariatric surgery are underutilised. Restricted access to specialised care, high costs, a scarcity of educated obesity medicine and weight management specialists, and limited insurance coverage are all significant impediments to their usage and effective long-term weight control.

The study’s authors point out that a significant obstacle to effective care is a lack of access to healthcare specialists trained in obesity medicine and interdisciplinary treatment teams. Geographical limitations, especially in rural locations, significantly limit access to care, according to the authors. Obesity treatment may also be limited due to a perceived lack of time and a low priority given to it during primary care appointments. “Weight-management programme performance improves with more frequent visits,” the authors write.

According to a 2016 survey by the United States Department of Health and Human Services, telemedicine was used by 61 percent of healthcare institutions in the US. Because most patients are incapable, unwilling, or dissuaded from seeking therapy in person, the COVID-19 pandemic has accelerated the growth of telemedicine. Telehealth visits increased by 154 percent during the first year of the COVID-19 epidemic, according to the Centers for Disease Control and Prevention.

The authors argue there are multiple opportunities for telemedicine to address key barriers for improving obesity treatment. Primary care providers can make referrals to specialists beyond their geographic locations to improve access to care. A randomized clinical trial consisting of males and females that were socioeconomically disadvantaged with obesity and elevated risk for cardiovascular disease demonstrated greater weight loss with a digital app and clinician counseling.

Virtual contacts between patients and healthcare providers could be less costly and more efficient than in-person appointments. Spring et al. looked at specific components of behavioural obesity therapies, including those provided remotely, to see how cost-effective they were at contributing to weight loss over a six-month period. Nearly 60% of participants lost at least 5% of their baseline body weight as a result of the combination of treatment packages, which included a smartphone app, personalised goals, online lessons, 12 coaching calls, a support buddy, and progress reports sent to a primary care provider.

By decreasing the time and resource commitments needed for frequent counseling appointments, telemedicine may also help improve long-term adherence. In one study, patients who participated in a weight-loss intervention visit via videoconference, compared with those who attended in person, showed a 96% retention rate for those who participated virtually, compared to 70% for the in-person group.

The necessity for training of healthcare practitioners to deploy remote healthcare, as well as the licencing of secure videoconferencing software that complies with the Health Insurance Portability and Accountability Act, are both obstacles to telemedicine use. Other constraints may include patient access to a stable internet connection and insurance reimbursement problems.

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