The obesity epidemic continues at alarming rates with a high
burden to our economy and society. Patients with obesity need a multidisciplinary approach to achieve a
healthy weight, and the American Gastroenterological Association (AGA)
believes that gastroenterologists are in a unique position to lead the
To provide gastroenterologists with a comprehensive,
multi-disciplinary process to guide and personalize innovative obesity
care for safe and effective weight management, including a model for how
to operationalize business issues, AGA has created an Obesity Practice Guide.
‘The American Gastroenterological Association has created an Obesity Practice Guide to provide gastroenterologists with a comprehensive, multi-disciplinary process to guide and personalize obesity care.’
The program includes an obesity program to help gastroenterologists
manage their patients with obesity, as well as a framework focused on
the business operational issues related to the management of obese
patients, which are published in Clinical Gastroenterology and Hepatology
, the clinical practice journal of the American Gastroenterological Association.
Sarah Streett, an author of
both papers, chair of the AGA Institute Practice Management and
Economics Committee, and clinical associate professor and director of
IBD Stanford University School of Medicine, CA, said, "The American
Gastroenterological Association understands the importance of embracing
obesity as a chronic, relapsing disease and supports a multidisciplinary
approach to the management of obesity."
POWER: Practice Guide on Obesity and Weight Management, Education and Resources1
Obesity is a major modifiable cause of diseases of the digestive
tract that routinely goes unaddressed. Gastrointestinal disorders
resulting from obesity are more frequent and often present sooner than
type 2 diabetes mellitus and cardiovascular disease, which means
gastroenterologists have an opportunity to address obesity and provide
effective therapy for their patients.
Patients who are overweight or
obese are often seen by gastroenterologists due to gastroesophageal
reflux disease (GERD) and its associated risks of Barrett's esophagus
and esophageal cancer, gallstone disease, non-alcoholic fatty liver
disease and non-alcoholic steatohepatitis, and colon cancer. As
internists, specialists in digestive disorders and endoscopists,
gastroenterologists are in a unique position to play an important role
in the multidisciplinary treatment of obesity.
"We created the practice guide on obesity and weight management to
help gastroenterologists develop a multidisciplinary team and obesity
care model for their practice, including patient goal setting, readiness
assessment, evaluation, and treatment with diet, medication, and
bariatric endoscopy and surgery," said Andres Acosta, lead
author of the paper and assistant professor of medicine, Clinical
Enteric Neuroscience Translational and Epidemiological Research
(C.E.N.T.E.R.), division of gastroenterology and hepatology, Mayo
Clinic, Rochester, MN. "It is our hope that by working in a team-based
approach, gastroenterologists can guide and personalize obesity care for
safe and effective weight management for our patients."
The Society of American Gastrointestinal and Endoscopic Surgeons
(SAGES), The Obesity Society (TOS), and North American Society for
Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN)
contributed content to the POWER program, which was endorsed with input
by the American Society for Gastrointestinal Endoscopy (ASGE), American
Society for Metabolic and Bariatric Surgery (ASMBS), American
Association for the Study of Liver Diseases (AASLD), Obesity Medicine
Association (OMA) and Academy of Nutrition and Dietetics (AND).
Episode-of-Care Framework for the Management of Obesity: Moving Towards High Value, High Quality Care2
The treatment of obesity needs a collaborative approach involving
multiple stakeholders. AGA established an obesity episode of care model
to develop a framework to support value-based management of patients
with obesity, focusing on the provision of non-surgical and endoscopic
services. The framework will help gastroenterology practices assess
their ability to participate in and implement an episode of care for
obesity, and understand the essentials of coding and billing for these
The goal of episode framework is to provide gastroenterologists with
strategies to obtain compensation for high value care, in a flexible
format that can be adapted to the resources of both large and small
practices. It is essential that data coordination take place between all
members of the multi-disciplinary team who are providing therapeutic
services to the patient to ensure high value continuity of care.
The American Society for Metabolic and Bariatric Surgery (ASMBS),
American Psychological Association (APA), American Pharmacists
Association (APhA), and Academy of Nutrition and Dietetics (AND)
contributed to the obesity episode of care framework.