Obesity rates in the U.S. are at an all-time high and climbing. According to the CDC, from 2000 through March 2020, obesity prevalence increased from 30.5 percent to 41.9 percent. During the same time, the prevalence of severe obesity increased from 4.7 percent to 9.2 percent.
After 21 years as a physician associate in family medicine, Nicole Chrysler, PA says alarming obesity rates led her to dedicate her Hawaii-based practice to helping patients lose weight.
Chrysler, who owns Achieve Health, sees obesity rates continuing to rise and says the need for more physician associates (PA) in the field is massive.
Weight loss leads to decreasing comorbidities
The rate of obesity has coincided with an increase in comorbidities like Type 2 diabetes. About 1 in 10 Americans have diabetes, according to the CDC. Approximately 90-95 percent of them have Type 2 diabetes.
While many providers focus on helping patients manage the disease, Chrysler is determined to reverse it whenever possible. “Weight loss reverses high glucose levels and insulin resistance, sometimes enabling patients to decrease their medications or go off of them completely,” she says.
Chrysler estimates she’s supported many thousands of patients in her career. The best medicine, she says, is getting them to a healthy body mass index (BMI) or even an overweight BMI instead of the morbidly obese category. With her diabetic patients, especially, “It prevents them from taking 10 medications at a time and from leg wounds, decreased circulation and even amputations.”
Many patients stand out for Chrysler, but the ones where she can increase mobility stick with her especially.
One patient, for example, was confined to a wheelchair because her diabetes caused neuropathy wounds on her legs. With Chrysler’s help, she transitioned from a wheelchair to a walker. Then she even got rid of her walker. “When you make that kind of change – you go from someone who is covered in wounds and told she’ll never walk again to walking out of your office with a giant smile – that really sticks with you,” says Chrysler.
How one PA makes weight loss attainable
Significant lifestyle changes are never easy. But the help of a healthy weight provider makes it a lot easier. Chrysler supports patients’ goals to lose weight in three ways.
- Mindset shifts: In the first meeting with new patients, Chrysler explains in detail what patients can expect for the next 3-6 months of their lives. She helps patients set realistic goals and envision how to achieve them.
- Healthy lifestyle changes: Based on each patient’s needs, Chrysler helps each one plan a healthy diet, sleep schedule and exercise routine. Together, they consider stress levels and how to reduce stress as well.
- Medication: Chrysler typically prescribes Phentermine to reduce appetite. Unlike the newer medication, like Ozempic, it’s a temporary prescription.
“The way that I think a lot of medical providers go wrong is they just give out the prescription with no plan for behavioral change. If there’s no mindset and lifestyle change, they just take the pill and then come back and weigh the same because their calories went up or they didn’t exercise, or they weren’t sleeping and their cortisol levels are high,” says Chrysler.
Foundational to patients’ success is what brings them to Chrysler in the first place – their initial desire and willingness to change. She sometimes turns patients away when it’s evident in the initial meeting that they’re just looking to take medication without making other changes.
“We have a lot of great medications out there, but what works the best is getting the body healthy again, eating properly, getting movement and getting enough sleep,” says Chrysler.
Why physician associates are positioned to support weight loss
Physician associates – also called physician assistants – are well-equipped to help patients with weight loss treatment. PAs have a comprehensive education and experience that covers a wide range of healthcare areas. They have a strong foundation in anatomy, physiology, pharmacology and other core medical sciences, which is crucial for understanding the complexities of weight-related diseases and treatments.
One of the challenges for providers working in weight loss, though, is that many insurance policies don’t consider obesity a medical condition. It’s often categorized as cosmetic and has to be paid for privately. Alternatively, providers have to list other comorbidities to get treatment covered by insurance.
As insurance policies change, there will be more PA providers like Chrysler available to support patients. The need, says Chrysler, has never been more urgent.
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