Toolkit provides framework for management of obesity

Research finds that overweight and obesity can have considerable health and psychological consequences for all people, and primary care teams need tools and resources to properly address this disease. Now defined as a disease by the American Medical Association, obesity is a complex medical condition that is linked to premature death from type 2 diabetes, heart disease and certain cancers.

The Gerontological Society of America KAER Toolkit for the Management of Obesity in Older Adults seeks to equip primary care teams with a useful framework to help older people with overweight and obesity recognize and care for their condition.

Overweight and obesity can also have considerable psychological implications including feelings of shame, low self-esteem, and mood problems in addition to its impact on function and mobility. Not only does overweight and obesity disproportionately impact racial and ethnic groups and individuals with lower income and educational attainment; for older adults, additional chronic medical conditions make addressing overweight and obesity complex. According to the Centers for Disease Control and Prevention, 41.5 percent of Americans aged 60 years or older are obese.

Despite the implications of overweight and obesity on older adults' overall health and well-being, primary care teams may fail to address it.

"Primary care physicians and providers are often challenged when they care for patients with obesity. This concern for competence is a derivative of inadequate training in obesity," said Fatima Cody Stanford, MD, MPH, MPA, MBA, FAAP, FACP, FAHA, FAMWA, FTOS, an associate professor of medicine and pediatrics at Harvard Medical School and an obesity medicine physician-scientist at Massachusetts General Hospital.

"This toolkit serves as a reference for any clinician who seeks to provide patient-centered care for this patient population," added Cody Stanford, who served as a peer review panelist for the new KAER Toolkit.

In 2015, GSA developed a framework that is useful for primary care teams to address obesity: the KAER (Kickstart, Assess, Evaluate, Refer) Framework.

Using this framework, GSA developed the GSA KAER Toolkit for Primary Care Teams aimed at supporting the well-being and positive health-related outcomes for people living with dementia and for their families.

Building on the success of this widely recognized toolkit and with the support of Novo Nordisk, GSA developed the The Gerontological Society of America KAER Toolkit for the Management of Obesity in Older Adults. Its principal audience is primary care teams and it supports them to:

• Kickstart the weight management conversation in the primary care setting with a focus on obesity as a disease, not a behavioral issue or problem based on poor choices
• Assess for overweight and obesity, underlying conditions, contributing medications, and overall health
• Evaluate treatment options based on assessment, discuss with patient, implement, and monitor outcomes
• Refer for community resources to assist on the weight management journey

In addition to a section devoted to each of the above-noted four steps in the KAER Framework that includes section takeaways, an overview, and approaches to implement, the toolkit includes information about ways to get paid for KAER-based care and many references and resources. GSA also makes available additional resources regarding overweight and obesity, including podcasts, publications, and more.

"We are grateful to our peer review panel who informed the development of the KAER Toolkit," said Karen Tracy, vice president, strategic alliances and integrated communications at GSA. "Their expertise allowed us to infuse the toolkit with the best available tools and resources for primary care teams to use while providing care to older adults with overweight and obesity. The toolkit includes important information that supports primary care teams to identify and address their own biases and practices that impede person-centered, sensitive care for individuals with overweight and obesity—an important first step in implementing the KAER Framework to support older adults with these chronic and complex conditions."