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Dr. Ciudin: 
This is CME on ReachMD, and I'm Dr. Andreea Ciudin. Here with me is Marta Comas.

Marta, please can you tell us how providers in a multidisciplinary team can work together in the obesity management?

Dr. Comas: 
Of course. I think it's very important to establish multidisciplinary teams in obesity treatment units. Coordination can be carried out by the medical practitioner with the support of different figures, like the endocrinologist, the nutritionist, physiologist, nurse, physiotherapist, and maybe surgeon if it needs to be included in the team.

And to understand the motivations of individual patients and the goals we have to establish, I think it's very useful to use shared decision-making protocols. I don't know what you think about that. But the patients can be involved in the management of their disease, and these protocols help patients to express her motivations, beliefs, aspirations, preferences, and values. So the goals must go beyond the weight values, because weight is an absolute value, but doesn't give us information about body composition, quality, or health level from our patients. And we have to put an eye maybe on percentage of fat, the improvement of patients, the quality of life of our patients, other comorbidities, for example. Because for patients, I think it's important how to perform her daily life without difficulties.

Obviously, the management medications, it's also a topic about we believe that, depending on the type of obesity we have, this kind of treatment will be chronic, maybe other times could be temporary or in other cases recurrent. So in that kind of drugs, the main limitation we have is the price. I don't know in other countries in the world, but here, they are not reimbursed. But we hope in the future it could be.

So one of the main worries we have in our daily practice is the main side effects that has these kind of medications, but they are mainly gastrointestinal and self-limiting due to the mechanism of the drug itself. Adjusting the diet usually produce beneficial effects. So I think it's a bit resume of the situation here.

Dr. Ciudin: 
Yeah, thank you, Marta. Actually, I fully agree with you that the shared decision-making process is very important because it puts the patient in the center and actually empowers patient. And I think that you may agree with me that patients have to be part of this multidisciplinary team. It’s not just about including healthcare professionals.

And maybe the key messages of this talk is that it's very important to bear in mind that obesity refers to a group of chronic heterogeneous diseases that result from the complex interaction of multiple factors such as biology, such genetics, psychological, environmental. And furthermore, it's important to bear in mind that these factors can change and can combine in a different manner during the lifespan of a person living with obesity. So for this reason, as you mentioned, a multidisciplinary approach is needed for the management of obesity. For the obesity management medication, we have to do a very exhaustive evaluation of the patients with obesity. And from this, in this team, many different providers have to work together in a transversal and continuous manner and including patients.

So I think it's been a great discussion, but our time is up, so thank you very much for listening.

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