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Experimenting And Reevaluating

If there is one thing for sure, when it comes to managing obesity, one size does not fit all. In the same manner as there are hundreds of paths that lead to obesity, predicting the treatment that works best for any given patient is almost impossible – what works for one, may do nothing for another (treatments fail patients, patients never fail treatments).

Thus, in our analysis of interviews with patients and providers, published in Clinical Obesity, the eighth theme that emerged, was the importance of experimenting and reevaluating.

“Participants experimented with different actions, arranged appointments with interdisciplinary providers, or tried out community resources. Some changed their action plan and implemented different behaviours inspired through the consultation. During follow-up interviews, people reflected on what worked, what did not and what needed adjusting. Participants found that having someone ask how things are going was helpful for accountability and motivation. These conversations also helped them develop solutions for barriers.

It became glaringly obvious that, as with any other chronic disease, obesity care needs creating a supportive long-term relationship in order to respond to emerging barriers, shifting experiences, illness and treatment burden – what works great at one point may stop working when situations change. Things that seem impossible at first may well become possible over time.

If there is one thing that I have learnt in my dealing with patients, it is modesty in professing to have the solution for every problem.

As I have said, people who think there is a simple answer to every question, generally don’t even understand the question.

Madrid, ES

1 Comment

  1. Prof Sharma,

    In your most recent Obesity Notes (“Experimenting And Reevaluating”, Posted: 29 Nov 2018) the final 3 paragraphs succinctly describe professional behaviors I would expect to see in any mature, empathic physician. Sadly, many of our peers have accepted the noxious pressures that tend to require more impulsive and rigid patterns of “doctoring”.

    Thank you for these reminders about intellectual and emotional honesty. As I enjoyed your post, I was reminded of a similar article published in the past month [Schiff GD, et al. (2018). “Ten principles for more conservative, care-full diagnosis.” Ann Intern Med 169(9): 643-645. PMID 30285046]. The first 5 of their 10 principles express thoughts similar to yours. Readers of Obesity Notes will appreciate the need to rebel against hasty diagnoses and inattention to patient wishes.

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