Let’s Talk About Weight (Part 3)Saturday, January 8, 2011
Today’s post is another excerpt from “Best Weight: A Practical Guide to Office-Based Weight Management“, recently published by the Canadian Obesity Network.
This guide is meant for health professionals dealing with obese clients and is NOT a self-management tool or weight-loss program. However, I assume that even general readers may find some of this material of interest.
Let’s Talk About Weight (Part 3)
Motivation: Intrinsic vs. Extrinsic
Try to find out whether the motivation for weight loss comes from the patient themself or from someone else. If the desire is extrinsic, it is worth exploring why the patient feels that the other person wants them to lose weight. Obesity treatment is unlikely to be successful unless the patient wants it themselves; losing weight to please someone else may not provide sufficient motivation, and may in fact cultivate eating-based oppositional defiance.
If the primary motivation is coming from within, it is important to know what kind of support system the patient can count on. Will their efforts be supported or sabotaged at home? How committed are partners to supporting the treatment effort? Is the family ready to change? Statements such as “We always have soda and chips in the house for the kids,” “My mother-in-law always brings us food,” or “My husband demands three cooked meals a day,” can indicate a less-than-supportive environment. Friends can also play an important role. If a patient’s circle of friends regularly centres social gatherings on eating, this will certainly have an impact on your patient’s likelihood of success.
Why Lose Weight Now?
It is worthwhile to try and understand a patient’s timing. Is now really the best time? Weight loss requires considerable mental and physical effort. It may not be best to embark on a weight-management effort if the patient expects to be facing periods of stress or immobility in the near future. On the other hand, changes in circumstance, such as a new job or relationship, may provide a good opportunity to alter established patterns and habits that have perpetuated weight gain.
Readiness for Change
Prochaska’s Readiness for Change model provides a reasonable guide for the clinician’s efforts to advise patients about weight management. While there is little point in trying to convince someone who is at a pre-contemplation stage, carefully-worded advice to those in the preparation, action, maintenance and relapse stages can be highly effective. The patient who desires to lose weight has clearly reached at least the preparation stage, and may already be at the action stage. Understanding which stage of change a patient has reached is crucial for delivering advice and encouragement that can prompt, or sustain, a patient’s efforts.
© Copyright 2010 by Dr. Arya M. Sharma and Dr. Yoni Freedhoff. All rights reserved.
The opinions in this book are those of the authors and do not represent those of the Canadian Obesity Network.
Members of the Canadian Obesity Network can download Best Weight for free.