An Integrative Approach to Treating Obesity and Comorbid Medical Disorders

  • Roderick Bacho
  • John Myhre
  • Larry C. James

Psychologists and other behavioral health specialists (BHS) are playing an increasingly larger role in primary care. In such settings, they routinely work with patients who require them to possess greater knowledge about the complex interactions between medical conditions, social circumstance, and psychological pathology. In some economically challenged settings, the combination of poverty, poor nutrition, and limited access to comprehensive medical services has resulted in an explosion of obesity and its related medical consequences. These consequences have included increased prevalence of diabetes, heart disease, and strokes. Social and economic stressors have also taken their toll, resulting in high rates of unhealthy lifestyle choices and treatment adherence problems. These socioeconomic and behavioral complications have affected medical treatment outcome for these diseases. Nowhere is this phenomenon more evident than in rural clinics and medically underserved populations. As a consequence, primary care providers in these settings frequently treat patients diagnosed with comorbid medical and psychological conditions. Typically, these conditions co-occur in the context of complex social issues, logistical, and cultural barriers. These barriers oftentimes adversely impact their access to care. In recent years, the addition of fellowship-trained BHS to the primary care team has resulted in improved access and improved quality of care, but there is still much left to do.

This chapter will attempt to establish the premise that BHS can manage medically complex patients with comorbid mental health conditions in a medical setting. Furthermore, it will be asserted that BHS with additional training and clinical supervision are well situated to more completely address a patient’s biopsychosocial needs than traditional medical providers alone.


Primary Care Physician Behavioral Health Psychotropic Medication None None Primary Care Team 


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Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Roderick Bacho
    • 1
  • John Myhre
    • 1
  • Larry C. James
    • 1
  1. 1.Department of PsychologyTripler Army Medical CenterHawaiiUSA

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