Let’s Talk About WeightSaturday, December 11, 2010
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
While there are many ways to begin helping patients manage their weight, some work better than others. Many patients will not bring up the subject of weight loss on their own and may dread the idea of their doctor broaching the topic. In these circumstances, setting the right tone is an essential first step.
This chapter looks at good and bad ways to approach the subject of weight management. It begins with three common approaches we cannot recommend, then explores a more open-ended, collaborative approach designed to establish a rapport and earn your patient’s trust.
WRONG APPROACH #1: SCARE TACTICS
“If you don’t lose weight soon, you’re going to kill yourself!”
Your patients know their weight puts them at risk — they experience its health impacts every day, which is why they are currently sitting in your office. Scaring a patient will only increase the insecurities they arrived with, and will do nothing to positively motivate them to change their situation. Willpower diminishes with a sense of failure, and even the most committed patient may initially balk at a weight-loss program because of feelings of inadequacy — after all, a lack of success in this area is what drove your patients to seek you out in the first place. Self-confidence is key, and scare tactics are never reassuring and may even paralyze patients into inaction. Given the drastic effort needed to lose weight, paralysis is the last thing you want to induce.
WRONG APPROACH #2: SLOGANS AND STOCK PHRASES
“Eat less; exercise more.”
Slogans may work in mass advertising; they come off as trite with an audience of one. Nobody likes being patronized, which is the only thing these stock phrases achieve.
Utter them and your patients will know for sure that you have absolutely no understanding of the complexities of their situation. If it were that easy, all your patients would be skinny, and we would not be writing this book.
WRONG APPROACH #3: GUILT
“Don’t you care about your health?”
Backing your patient into the “guilt corner” only serves to erode the doctor-patient relationship. Guilt is something the severely obese already have in abundance.
A COLLABORATIVE APPROACH
“I’m sure you’re aware that your weight can affect your health. Do you have any concerns about your weight and health that you’d like to talk about?”
Here, the approach is collaborative. You open the door to conversation, but allow your patient to steer where it will go. While a large percentage of patients with excess weight want to lose it, not all are ready to actually start making changes. The question above allows you to determine what stage of change your patient has reached. For the patient who has reached a pre-contemplation stage (see the section on page 7 on Readiness for Change), this open-ended approach might steer them towards contemplation. Those already contemplating a weight-loss effort may move to the next stage of preparation.
© 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.