Specialists offer ideas for obesity management

Richard A. Dickey, MD, vice president of the American Association of Endocrinologists and a private practitioner in Hickory, NC, and Xavier Pi-Sunyer, MD, director of endocrinology at St. Luke's Roosevelt Hospital in New York City, offer the following suggestions for managing obesity as a chronic disease:

· Treat patients in group settings. To change behavior for the long-run, patients need social support. Pair patients for a "buddy system" that holds them accountable to one another.

· Involve family members in lifestyle changes.

· Use a team approach, including nutritionists, psychologists, and exercise specialists.

· Individualize the program according to the patient's likes and dislikes, support systems, and work conditions.

· Offer weekly counseling.

· Give patients a specific meal plan to help reduce caloric intake. Liquid supplements may be helpful.

· Use an optimistic approach that is accepting of the patient.