Defining Integrated Care for Obesity

7/5/2021 2:17:00 PM | Defining Med;Medical News

The article is contributed/written by Obesity Centre

Overweight and obesity have become serious public health issues worldwide. Research has shown that being overweight or obese increases one’s risk of developing many chronic illnesses such as diabetes and cardiac diseases. Adopting a healthy lifestyle to achieve meaningful weight loss can significantly reduce the risk of developing these diseases. The Singapore General Hospital (SGH) Obesity Centre was formed to bring together healthcare professionals across disciplines to cater to these needs.

ABOUT THE SGH OBESITY CENTRE

The SGH Obesity Centre uses evidence-based integrated approaches to help people with obesity lead a healthier lifestyle and, in the process, achieve sustained weight loss, weight maintenance and improved health for themselves.

The Centre’s multidisciplinary team consists of endocrinologists, surgeons, gastroenterologists, dietitians, physiotherapists, psychologists, pharmacists, specialty nurses and clinical coordinators – all of whom play an important role in holistic patient care.

OUR SERVICES

Medical Weight Loss
Metabolic Bariatric Surgery
Endoscopic Bariatric Procedures
Allied Health / Lifestyle Interventions
Bariatric Support Group

SHARED CARE WITH GPs

We welcome the opportunity to co-manage patients with general practitioners (GPs), who remain central to their care.

It is common for patients to see the dietitians, physiotherapists and psychologists at the Centre, while continuing to follow up with their GPs for chronic medical conditions. Patients who have their own GP may also only see the Centre’s endocrinologists once or twice yearly, to check on their weight loss progress.

How GPs Can Refer: GP Referral Criteria
OBESITY MANAGEMENT Patients MUST have/be: Willing to commit to at least 12 weeks of obesity treatment Motivated to make lifestyle changes and willing to participate in moderately intensive physical activity BMI ≥ 27.5 kg/m² OR BMI ≥ 23.5 kg/m² with ANY of the comorbid conditions below: Type 2 diabetes mellitus or impaired fasting glucose, impaired glucose tolerance, history of gestational diabetes mellitus Coronary heart disease, hypertension Dyslipidaemia (low HDL / high LDL / high triglyceride) Obstructive sleep apnoea (diagnosed) Fatty liver with abnormal liver function tests Osteoarthritis (knees, back) Polycystic ovarian syndrome	LIPID DISORDER MANAGEMENT Patient intolerant of lipid medication Patient not achieving targets with usual lipid medication BARIATRIC SURGERY BMI ≥ 37.5 kg/m²OR BMI ≥ 32.5 kg/m2 with ANY of the comorbid conditions listed BARIATRIC – ENDOSCOPIC MANAGEMENT BMI ≥ 27.5 kg/m2 to ≤ 32.5 kg/m² with or without the comorbid conditions listed OR Patient with obesity not fulfilling criteria/unwilling for bariatric surgery

How GPs Can Refer: GP Referral Criteria

OBESITY MANAGEMENT

Patients MUST have/be:

Willing to commit to at least 12 weeks of obesity treatment
Motivated to make lifestyle changes and willing to participate in moderately intensive physical activity
BMI ≥ 27.5 kg/m²
OR
BMI ≥ 23.5 kg/m² with ANY of the comorbid conditions below:

Type 2 diabetes mellitus or impaired fasting glucose, impaired glucose tolerance, history of gestational diabetes mellitus
Coronary heart disease, hypertension
Dyslipidaemia (low HDL / high LDL / high triglyceride)
Obstructive sleep apnoea (diagnosed)
Fatty liver with abnormal liver function tests
Osteoarthritis (knees, back)
Polycystic ovarian syndrome

LIPID DISORDER MANAGEMENT

Patient intolerant of lipid medication
Patient not achieving targets with usual lipid medication

BARIATRIC SURGERY

BMI ≥ 37.5 kg/m²OR
BMI ≥ 32.5 kg/m2 with ANY of the comorbid conditions listed

BARIATRIC – ENDOSCOPIC MANAGEMENT

BMI ≥ 27.5 kg/m2 to ≤ 32.5 kg/m² with or without the comorbid conditions listed
OR
Patient with obesity not fulfilling criteria/unwilling for bariatric surgery