In Reply: We thank Dr. Modesto-Lowe and colleagues for their comments. We agree that primary care providers need to increase their efforts to diagnose patients with obesity and adiposity-related comorbidities and to discuss with patients the therapeutic options including behavioral, pharmacotherapy, and possibly bariatric surgery. Pharmacotherapy should not be considered a last resort as antiobesity agents are safe and effective and should be offered for patients with a body mass index of 30 kg/m2 or greater and with a body mass index over 27 kg/m2 in the presence of obesity-related comorbidity. Though we also recognize that the cost of antiobesity medications and the lack of insurance coverage for them continue to be major barriers to the regular use of these agents.
In general, primary care doctors need to become more comfortable discussing obesity as a medical problem that requires treatment like all other medical problems.
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