Frank A
Washington University Obesity Management Program, George Washington University School of Medicine, Washington, DC 20037, USA.
J Am Diet Assoc. 1998 Oct;98(10 Suppl 2):S44-8. doi: 10.1016/s0002-8223(98)00710-x.
The increasing perception of obesity as a disease is likely to encourage the presumption that obesity ought to be medicalized and managed in the format of a traditional disease model by the existing health care system. Many difficulties will arise from this approach because of factors such as the large numbers of affected patients, the inadequacy of health professionals' training, negative cultural views of obesity, and the inadequacy of financing (ie, health insurance) mechanisms. A series of conflicting expectations related to the services that can be provided by physicians will reinforce their reluctance to manage this disease. Much of the care of obese patients can, however, be provided by a nonphysician primary obesity care provider or team with the physician providing selected support services. Models of a modified team care system, using selected and specific nonphysician personnel and involving the patient in continuing management, may offer some new and effective options for the care of obese patients.
将肥胖视为一种疾病的观念日益增强,这可能会促使人们假定肥胖应该由现有的医疗保健系统按照传统疾病模式进行医学化处理和管理。由于诸如受影响患者数量众多、医护人员培训不足、对肥胖的负面文化观念以及融资(即医疗保险)机制不完善等因素,这种方法会引发诸多困难。与医生所能提供的服务相关的一系列相互冲突的期望,将强化他们对管理这种疾病的抵触情绪。然而,肥胖患者的许多护理工作可以由非医生的初级肥胖护理提供者或团队来提供,医生则提供特定的支持服务。采用经过挑选的特定非医生人员并让患者参与持续管理的改良团队护理系统模式,可能为肥胖患者的护理提供一些新的有效选择。