Treating Obesity and Other Related Conditions with Telehealth

According to the Health Resources Services Administration, telehealth may be defined as "the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration." Telehealth has the potential to improve the treatment of overweight, obesity and related diseases.

A Finnish study analyzed the outcomes of their healthy weight coaching (HWC) program. This is a "web-based obesity management program integrated into standard Finnish clinical care." The program lasts 12 months. And the participants receive coaching support, remotely, in a one-on-one format. The researchers concluded that the HWC is an effective program for helping participants lose weight. And that the program can be integrated into a clinical setting.  

A 2009 study was done in Ottawa Canada to determine the effectiveness of telehealth for home health care. In the study, literature was analyzed to compare the benefits of treating diabetes using telehealth versus treating diabetes using common diabetes treatment procedures. It was found that patients who received treatment via telehealth had a higher quality of life, and experienced less hospitalization than diabetes patients receiving the normal diabetes treatment.

Although the leaders of the Canadian study indicated that more research needs to be done, as stated above, telehealth improved quality-of life and reduced hospitalizations. The use of telehealth also improved glycemic control and patient satisfaction.

A 2007 study was done in the United States to establish the effectiveness of telehealth in treating obesity.  Three weight loss programs were compared. These programs were telehealth, traditional classes, and no program. The study looked at the amount of weight participants regained in each program. The study also assessed a participants' satisfaction with a given program, and the convenience of a program for the participants. Participants in the telehealth program lost slightly more weight than participants in the other two programs.

However, the difference in weight loss was not enormous. But the telehealth group found the telehealth program to be more convenient. And convenience  is important in trying to modify a lifestyle. If one program is more convenient to follow than another, a person is more likely to follow the more convenient program.

Telehealth may elevate the treatment of obesity by making it easier to modify lifestyle. Healthcare providers are paying close attention to telehealth methodology, not only in the fight again overweight and obesity, but, also, in the treatment of other medical conditions.

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We Need to Heighten the Treatment of Prediabetes in the Primary Care Setting

 A person with prediabetes is at a high risk of developing type 2 diabetes. Kidney difficulties, cardiac problems, strokes, and other comorbidities can all be caused by type 2 diabetes. As a result, both healthcare and community organizations are developing programs to fight prediabetes in the hopes of delaying or preventing type 2 diabetes.
However, primary care organizations must play a larger role in the treatment of prediabetes. And, at the moment, these groups are not engaged in the treatment to the extent that they could.

In a recent study, researchers looked at 3888 patients who were diagnosed with prediabetes based on lab results. The diagnoses were later confirmed. However, only 10.4% of the patients were coded as having prediabetes. Only 5.4% received a prescription for metformin, and only 1.0% of the patients received a nutrition-services referral.

Few individuals with untreated prediabetes are ever notified that they are at high risk for diabetes, according to one study. Furthermore, the study concluded that better patient-centered treatment is required for diabetes prevention, which begins by giving the patients more information.

Primary care organizations, on the other hand, are reticent to diagnose and treat prediabetes for a variety of reasons. There is only a vague understanding of what prediabetes is, and some people do not believe it is a disease. Some argue that because the patient already has enough to worry about, it's not a good idea to give him or her more issues to be concerned about.
 
Other factors contribute to primary care organizations' refusal to provide prediabetes therapy. According to one study, clinicians may be unaware of how successful interventions are at reducing diabetes risk. There may also be a "lack of access to providers of dietary and exercise advice."

In any case, in order to avoid or delay type 2 diabetes, more attention should be paid to the diagnosis and treatment of prediabetes.
And the CDC's National Diabetes Prevention Program (DPP) is a terrific place to start.

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Sedentary Lifestyle Can Be a Factor in Low Back Pain

A sedentary lifestyle is one where an individual gets very little exercise. And people all over the world are getting less and less exercise. During their leisure time, people sit while using computers, watching TV or playing video games. And at work, people often do their job while sitting at a desk.  A sedentary lifestyle can increase a person’s risk for many cardiometabolic problems including obesity, heart disease, high blood pressure and cholesterol. And a recent study has shown that a sedentary lifestyle can also raise the risk for low back pain (LBP).

There are basically two types of back pain. There is acute back pain that may last up to a few weeks, and there is chronic back pain that can last 12 weeks or more. Most of us experience back pain at some point, but the back pain usually goes away. However, LBP is a chronic condition for about twenty percent of the people who have the condition.

In the study mentioned above, 27 meta-analyses were researched. The meta-analyses were taken from articles published in PubMed, Embase, Web of Science, and Scopus. And the analysis of the 27 meta-analyses showed that sedentary lifestyle raised the risk of LBP.

The set of meta-analyses showed that a sedentary lifestyle was a big risk factor for LBP in both adults and children. For example, one of the meta-analyses showed that using a computer for more than four hours a day, while at work, could lead to LBP. One of the analyses indicated that sitting for more than seven hours a day can lead to LBP. And another one of the analyses concluded that playing video games for at least twelve hours a week could lead to LBP.

Since a sedentary lifestyle can lead to LBP, exercise should be encouraged by healthcare providers for patients to prevent LBP, as well as other undesirable health conditions. 

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Tags: environmental scanning, balanced scorecard, business planning, strategic management, bariatric industry analysis, weight loss industry analysis, weight management industry analysis, prediabetes

Motivational Interviewing Can Be Used to Treat Peripheral Arterial Disease

The narrowing or blockage of the veins that transport blood from the heart to the legs is known as peripheral arterial disease (PAD). The accumulation of fatty plaque in the arteries, known as atherosclerosis, is the primary reason for the condition. PAD may affect any artery, however, it affects the legs more often than the arms. Walking can benefit individuals with PAD. And a study has shown that motivational interviewing (MI) methods can encourage individuals with PAD to walk.

Patients with PAD benefit from walking because it improves their ability to function. The above-mentioned study was done to examine the effectiveness of a smartphone app in increasing walking distance and boosting weight reduction in overweight/obese individuals with PAD, compared to the effectiveness of motivational interviewing.

Researchers at the University of Kansas performed a 3-month, randomized study consisting of 29 participants. The participants’ average age was 66. A BMI greater than 27 and symptomatic PAD were both required for inclusion in the study. Participants were randomly assigned to one of two groups: an MI group where in-person and telephone counseling was used or an app group where a mobile smartphone app was used.

Both treatment approaches promoted walking, for exercise, and good eating habits (increasing fruits and vegetables and whole grains while reducing fat and sugary drinks). At the start of the study, the researchers looked at the participants' medical history. A baseline assessment was made to determine how far a participant could walk in 6 minutes, along with a determination of each participant’s weight, quality of life, exercise practices, and eating habits. The participants were assessed again at three months.

After 3 months, the MI participants increased their 6-minute walking distance by 40 meters, while the app participants' increase in their 6-minute walking distance was not statistically significant. And the weight loss for the MI participants was 10.1 lbs., while the app participants lost about 2.3 lbs. There were no statistically significant changes in quality of life, exercise routines, or food habits when comparing baseline to 3 months for either the MI group or the app group.

The researchers concluded that that MI may help overweight/obese persons, with PAD, exercise more and lose weight. Healthcare providers may want to look at the results of the study. MI is a very powerful treatment tool. And while the above study was a small study, becoming familiar with MI and employing MI can benefit PAD patients who are overweight or obese.

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Tags: environmental scanning, balanced scorecard, business planning, strategic management, bariatric industry analysis, weight loss industry analysis, weight management industry analysis, prediabetes

Our Bodies Compensate for Calories Burned Through Exercise, but Exercise is Still Important in Weight Loss

Research has shown that exercise, alone, will not lead to much weight loss. Generally, in order to lose appreciable weight, an individual needs to follow a diet, designed to promote weight loss. One of the reasons why exercise, alone, does not lead to a lot of weight loss is that our bodies compensate for the calories burned through exercise by limiting the amount of weight we actually lose. Still, as one study has indicated, exercise can be helpful in weight loss, if the exercise is combined with a weight-loss diet.

According to a study on how physical activity affects our bodies, for every 100 calories we might think we will burn when we work out, most of us will only burn 72 calories. The study found that our bodies tend to make up for at least a quarter of the calories we burn when we work out. This makes it more difficult for us to lose weight by working out. Results also show that extra weight makes it even more difficult for people, who are already overweight, to exercise to lose weight.

However, let’s not discard exercise in the overall process of weight loss. A study was done to see if changes in physical activity (PA) are linked to important changes in body weight and other body measurements when the exercise is combined with a weight-loss diet.

The study looked at 535 overweight or obese subjects. The subjects were randomly assigned to one of four different weight-loss diets, each diet consisting of different macronutrients. PA was measured with pedometers. Body composition and fat distribution were measured with DEXA and CT scans at baseline, at 6 months, and at 24 months. Results from the study showed that for every 1000 daily steps taken, there was a measurable drop in "body weight, body composition, and fat distribution."

So, while exercise, alone, will not lead to much weight loss for most people, the combination of a proper weight-loss diet and exercise can lead to appreciable weight loss.

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Intermittent Fasting Can Treat Prediabetes

Prediabetes affects 88 million Americans, and most Americans don't know they have the condition. Intermittent fasting (IF) is a weight-loss approach that works well for weight loss and other cardiometabolic conditions. And using IF may be an effective treatment for individuals with prediabetes. A recent study done in China looked at 101 overweight and obese adults with prediabetes to determine if IF was effective in treating prediabetes.

For the study, the researchers used two forms of IF. They used alternate day fasting (ADF) where the participants were instructed to eat 600 calories in fasting days, and to eat normally on non-fasting days. The researchers also used a time restricted fasting (TRF)  protocol, where participants were instructed to fast for sixteen hours during a day, and eat normally during an eight hour period (16/8 TRF).

The participants were randomly assigned to one of three groups: 34 participants were assigned to the ADF group, 31 participants were assigned to the 16/8 TRF group, and 34 participants were assigned to the control group. The study lasted three months.

At the close of the study, the ADF and 16/8 TRF groups saw greater decreases in body weight, BMI, and waist circumference than the control group. And both intervention groups showed substantial decreases in blood sugars and lipids. The ADF group saw even greater weight and BMI reductions than the 16/8 TRF group.

The study suggests that incorporating intermittent fasting regimens into regular eating patterns might help people with prediabetes minimize their risk of diabetes and cardiovascular disease.

We know that weight loss is an important tool for lowering the glucose levels in people with prediabetes. And IF may be another weapon in the arsenal that providers can use to treat prediabetes.  Therefore, providers might want to consider IF for the treatment of prediabetes, as well as weight loss.

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Prediabetes Raises the Risk of All-Cause Mortality, and Diabetes-Related Conditions

The CDC estimates that 96 million American adults have prediabetes. And most persons with prediabetes don't know that they have the condition. The CDC’s Diabetes Prevention Program study that took place between 1996 and 2002 showed that lifestyle intervention can reduce the risk of progression from prediabetes to diabetes by 58% compared to people with prediabetes who were receiving usual care. And a recent study suggests that prediabetes raises the risk of all-cause mortality, comorbidities and complications.

The study was carried out by analyzing the results from different meta-analyses to determine how prediabetes is related to new cases of complications typically associated with diabetes. The researchers studied 4807 articles containing prediabetes-related meta-analyses. And the researchers narrowed the number of articles that fit the selection criteria to 16 articles, from which 95 meta-analyses were chosen.

The researchers concluded that “Prediabetes was associated with a higher relative risk of all-cause mortality and higher incidences of CV [cardiovascular] events, CHD [coronary heart disease], stroke, heart failure, atrial fibrillation, chronic kidney disease, total cancer, liver cancer, hepatocellular carcinoma, breast cancer and all-cause dementia with moderate certainty of evidence."

The researchers indicated that the incidence of the comorbidities and complications was lower for prediabetes than type 2 diabetes "suggesting a dose–response gradient in the relationship with complications."

The meta-analyses study highlights the importance of addressing prediabetes. We know that prediabetes raises the risk of diabetes. But the study shows that prediabetes raises the risk of other diseases. Therefore, healthcare providers should counsel at-risk prediabetes patients. They should work with the patients, if appropriate, to get the patients into a diabetes prevention program.

These programs can delay or prevent diabetes which could increase the lifespan of a person with prediabetes. Delaying or preventing diabetes can not only increase a person’s lifespan, it can also lower the person’s healthcare costs.

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Tags: environmental scanning, balanced scorecard, business planning, strategic management, bariatric industry analysis, weight loss industry analysis, weight management industry analysis, prediabetes