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Providers can develop lists of recommended providers in their community with experience caring for older adults with overweight and obesity and share these lists with appropriate patients. Obesity Care Providers, a website from the Obesity Action Coalition, may be helpful for identifying nearby specialists as well as dietitians, psychologists, and psychiatrists with experience treating obesity.
Referrals to obesity specialists may be appropriate, but access is often limited by the availability of providers and insurance coverage.
Older adults with overweight or obesity frequently live with multiple chronic conditions; weight-management care should therefore include an RDN to deliver individualized medical nutrition therapy that integrates disease-specific needs, mitigates risks (e.g., micronutrient deficiencies), improves cardiometabolic outcomes, and systematically screens for and addresses nutrition-related conditions such as sarcopenia/sarcopenic obesity and osteopenia/osteoporosis.
Assessment of an older adult’s nutritional status and need for dietary supplementation to ensure adequate intake of protein, vitamins, and minerals may also be performed by nutrition professionals.
Medicare Part B covers visits with an RDN for beneficiaries with diabetes or kidney disease; some Medicare Advantage plans offer broader coverage for weight management. Credentialed nutrition and dietetics practitioners can be found at eatright.org.
The behavior techniques listed below are foundational to obesity treatment and should be tailored to age-related cognitive, physical, and social factors (Koca et al., 2024).
The US Preventive Services Task Force recommends clinicians offer or refer adults with obesity to intensive, multicomponent behavioral interventions because they yield clinically meaningful weight loss and cardiometabolic risk reduction (USPSTF, 2018).
Importantly for Medicare beneficiaries, the Centers for Medicare& Medicaid Services (CMS) covers Intensive Behavioral Therapy for Obesity (National Coverage Determination 210.12), enabling structured counseling in primary care settings (CMS, 2011).
To address physical activity levels, referrals may be needed to physical therapists and exercise physiologists to create a safe physical activity program with both aerobic and resistance activities.
Interventions to support behavioral changes may also be needed and can include referrals to:
mental health professionals with expertise in obesity,
or to evidence-based programs that support behavioral modifications.
For details about this potential opportunity, see Chronic Care Management Services.
Ideally, the primary care provider collaborates with the interprofessional team to deliver coordinated patient-centered care.
Providers may be able to obtain reimbursement for managing the care of Medicare beneficiaries with multiple chronic conditions using chronic care management billing codes.
Although obesity is not listed as one of the qualifying conditions, qualifying conditions include those that are commonly associated with obesity (e.g., diabetes, hypertension, kidney disease).
Multidisciplinary and interprofessional team-based care is crucial... Work with a dietician, a physical therapist, or explore virtual or community-based senior fitness programs.
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