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Can Telehealth and Telemedicine Benefit Patients with Obesity?

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Can Telehealth and Telemedicine Benefit Patients with Obesity?

— By Dawn Sweet, Ph.D.

Integrating digital health practices in the form of telehealth or telemedicine can help overcome barriers and provide support for patients with obesity.

Telemedicine visits increased by just over 98,000 percent between 2005 and 2017, with 206 telemedicine sessions reported in 2005 and 202,374 telemedicine visits reported in 2017.1 The U.S. Centers for Disease Control reported that from the last week in March 2019 to the last week of March 2020, there was a 154 percent increase in telehealth visits.2 Since the COVID-19 pandemic, there has been clearly defined upward tick in offering patients health care via digital services.3 To date, digital tools have primarily been used in service of managing mental health, diabetes, and cardiovascular disease4,5,6, while its implementation in obesity care has been underutilized.3

Digital health care delivery can provide patients with obesity a more personalized experience and it is inclusive of technologies such as telemedicine, biosensors for remote diagnosis and monitoring, and smartphone apps, to name only a few tools.7 Integrating digital health care delivery into existing treatment programs for patients with obesity can reduce barriers and provide more personalized support for patients with obesity.

The Practice of Obesity Medicine

As noted in a 2021 study1, during the period of 2011 – 2018, just 19.6 percent of patients with pre-obesity or obesity received counseling for weight management from their health care provider in the previous 12 months. This suggests that there may be a lack of specialized care and knowledge available for some patients with pre-obesity or obesity. Given the complex and multifactorial nature of obesity, telemedicine represents a fertile space for reducing barriers to care and for patients with obesity to receive the treatment they need. Barriers to care include:

Access. Telemedicine can serve patients in rural or remote areas with limited access to health care providers who specialize in obesity medicine or who have experience with treating obesity.1 In a multidisciplinary behavioral weight management program8, patients in seven primary care practice in rural parts of South Carolina, clinically significant weight loss of 3.5 percent (or 3.8 kg average weight loss) was observed in 62 percent of patients who participated in the eight bi-weekly telemedicine sessions. The sessions were led by clinical psychologists, registered dieticians, and exercise physiologists.

Adherence. Telemedicine can reduce the time and resource commitments for the recurrent counseling sessions needed. A 20199 study found a higher retention rate in patients who participated in a weight-loss intervention via telemedicine (video conferencing) compared to those who attended in person, 96 percent and 70 percent respectively.

Options for Digital Health Care Delivery

Wearable devices that monitor and record health metrics such as physical activity, sleep, and heart rate have been shown to be successful tools for monitoring patients.3 As these technologies continue to develop, heart rhythms can be monitored in patients at risk for atrial fibrillation, which is an important metric for patients with obesity. Additionally, blood pressure, blood oxygen, and glucose levels could also be assessed via wearable devices.3

Just-in-time adaptive devices3 that use mental health sensors can deliver interventions via sensors in wearable devices, offering support when a change in the patient’s behavior is indicated. These just-in-time devices enable health care providers to see the behavioral context that is triggering a change in behavior, and support can be tailored to the trigger.3

Finally, Artificial Intelligence (AI) can be used to analyze large data sets and identify patterns that may not be otherwise identified. AI can also be used to create tailored and personalized diets via blood glucose monitoring.3

Implications for Clinical Practice: Telemedicine for the Treatment of Obesity

Obesity is a complex chronic health condition with a multitude of factors to consider; with that said, the integration of telemedicine and digital health care delivery tools warrant consideration. Digital health care could remove some barriers to care and help patients with obesity effectively manage and achieve weight loss. Despite its benefits, digital health care is not without some potential cons.

Relying more heavily on digital health care delivery may further exacerbate the digital divide and leave patients who can’t afford videoconferencing technology or wearable devices behind. Digital health care delivery could also leave behind patients who are not media literate. It is important for health care providers to explore digital health care delivery as one of the tools used to treat patients with obesity while remaining flexible in how best to serve their patients with obesity.

Sources:

1 The benefit of telemedicine in obesity care

2 Trends in the use of telehealth during the emergence of the COVID-19 pandemic — United States, January–March 2020. MMWR Morbidity and  Mortality Weekly Report

3 The potential role of digital health in obesity care

4 The effectiveness of telemental health: A 2013 review

5 Digital health technology and mobile devices for the management of diabetes mellitus: State of the art

6 Digital health approaches for cardiovascular diseases prevention and management: Lessons from preliminary studies

7 Preparing the health care workforce to deliver the digital future

8 Description, utilization and results from a telehealth primary care weight management intervention for adults with obesity in South Carolina

9 Development of a videoconference-adapted version of the community diabetes prevention program, and comparison of weight loss with in-person program delivery

About the Author: Dr. Dawn M. Sweet has over 20 years of experience in the field of communication. Dr. Sweet has given several invited talks to and workshops for academic and private sector audiences on the role of nonverbal and verbal communication in achieving positive outcomes and mitigating bias. Her research has been published in several top ranked peer-review journals, and it has been featured on NPR’s River to River / All Things Considered, Buzzfeed, and Science Daily. Her research has also been used to inform expert testimony.

About Robard: For 45 years, Robard Corporation’s medical obesity treatment programs and nutrition products have been utilized by physicians, surgeons and hospitals across the United States to successfully treat patients living with obesity. To learn more about us and how we can help your practice and patients, visit us online at www.Robard.com, email us at info@robard.com, or call (800) 222-9201.

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