Let’s Talk About Weight (Part 2)Saturday, December 18, 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 (Part 2)
Whether patients express interest in weight management after you initiate the discussion or start the discussion themselves, your first reaction should be to offer encouragement while gently probing their motives and goals. This is a good opportunity to determine whether your patient has realistic expectations and a plan for achieving their goals.
Ask “Why?” after patients state a desire to lose weight and they will certainly be surprised, but in a constructive way. More often than not they will explain their reasons or come back with a question such as “Don’t you think I should?” This type of conversation provides a valuable opportunity to learn about your patient’s motives and objectives.
Motivation: Aesthetics vs. Health
Aesthetics are a prime motivator for many people who want to lose weight. Do not make the mistake of equating this with superficiality before you have explored your patients’ motivation a little further. While going to a wedding or fitting into a bathing suit may not seem a strong foundation for long-term resolve, aesthetic considerations such as increasing self-esteem, improving sex life, dressing better or finding a partner, are all strong and reasonable reasons for initiating weight-management efforts.
However, it is important to emphasize that while weight loss may help them achieve appearance-related goals, it is not a remedy for relationship difficulties or psychological issues. A patient motivated primarily by the desire to improve a relationship or increase self-esteem may be less likely to achieve weight-management goals than one motivated by health reasons.
[Pearl: If weight loss is driven mainly by concerns over body image and self-esteem, then these issues need to be addressed. It may help to point out to these patients that “weight cycling” is a sure-fire way to keep gaining weight.]
If patients report improving health as their primary objective, we try to elicit specific examples of what should improve, such as increased energy or less knee pain. We then try to define objective quality-of-life or health goals that can be achieved within a reasonable time span; for one it may be to walk around the block or go to the mall, while for another it may be to reduce the need for blood pressure or pain medication. Sometimes short-term weight-loss goals for medical reasons can be reasonable objectives (e.g., weight loss prior to knee surgery). In all cases, success should be measured by the achievement of these goals rather than by the amount of weight actually lost. In fact, some of these goals, such as walking around the block or climbing stairs, can be achieved with no weight loss at all, just by increasing fitness. These successes should be highlighted.
[Pearl: The goal of weight loss should not be just to reduce numbers on a scale, but to reduce health risks and improve quality of life.]
© 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.