In this series, we look at ways urgent care centers can promote wellness for patients—help them keep those resolutions— in the New Year.
Davam Urgent Care in Texas is launching a comprehensive, evidence-based weight-loss program this year. In the next few months, Dr. Payman Arabsadeh—a member of the American Society of Bariatric Physicians— will start a program that includes counseling, body composition analysis, nutritional assessment, use of an app to track weight and exercise, meal plans and grocery lists, and approved medication. He and the Davam staff will coach patients on label reading, healthy cooking, and exercise.
“It’s something patients have been asking for,” Arabsadeh said. “They say they’re tired of the fad diets and they need something more supervised by a physician.”
Arabsadeh sees the need for urgent care centers to play a role in weight loss because obesity is such a pervasive problem across the U.S. More than one-third of U.S. adults are obese, according to a Journal of American Medicine, and obesity-related conditions (heart disease, stroke, type 2 diabetes, and certain types of cancer) are some of the leading causes of preventable death.
“Sometimes people use urgent care as primary care, so as a physician you have to be dedicated,” he said. “Patients need to educate themselves on weight loss, have strict guidelines to follow, so they don’t try weight loss in a way that’s not safe.”
In the largest study of its kind, researchers from the University of Michigan recently looked at 10 modifiable health risks in roughly 223,500 people across seven industries. Michael O'Donnell, an author on the study and director of the U-M Health Management Research Center, said: “There are hundreds of well-designed programs, but thousands of programs that are too superficial to have an impact. The best (wellness) programs increase awareness about the link between lifestyle and health, motivate people to change and build the skills necessary to do so, and provide opportunities to practice a healthy lifestyle."
Urgent care operators can both benefit from and take pride from encouraging weight loss in patients who really need to make a change. Most health insurance companies cover some or all of a medical weight loss program, especially if the patient has weight-related health conditions such as heart disease, diabetes or hypertension. If the insurance company does not cover treatment in an urgent care setting, a self-pay program may be arranged.
Fast Pace Urgent Care centers in Tennessee and Kentucky offer a weight loss program. Patients may qualify under the following criteria: A BMI greater than 30; or greater than 27 with a co-morbid condition such as type 2 diabetes, high blood pressure, sleep apnea, or high cholesterol.
An initial consult offered at the clinic often uncovers undiagnosed diabetes, high cholesterol, thyroid disorders, abnormal liver tests or obstructive sleep apnea. Then the clinician and patient discuss behavior modification and medication plans. There are several drugs approved for obesity treatment, including Phentermine, Orlistat, Lorcaserin, Phentermine-topiramate, and Lipotonix injections.
Patients schedule follow-up visits, usually frequent ones (every two to three weeks) until the initial weight-loss goals—5 to 10 percent of body weight—are met. At that point, less frequent appointments are scheduled as needed.
“Since obesity is considered a chronic life-long problem for many individuals, periodic follow-up is recommended on a continuous basis,” said Stan Bevis, founder of Fast Pace.
Arabsadeh’s program at Davam is designed for patients to lose 1 or 2 pounds each week, and they will come in for weekly weigh-ins and counseling sessions until they’ve achieved their goal. After that, he will follow up with monthly sessions and then maintenance as needed.
“We don’t do any drastic weight loss,” he said. “They will need coaching because this will be a total lifestyle change.”