Orient ExpressThursday, March 27, 2008
Yesterday we held another Orientation Forum for patients who have been referred to the Adult Weight Wise Program. Some have been waiting over a year for an appointment. Many are desperate for help. The average BMI of the 30 or so folks who attended the Forum was in the mid 40s – most have obesity-related comorbidities – clear indications for treatment.
So what did we orient them about?
Well, for one that obesity is a chronic disease and if they really want to deal with their weight problem, it will mean long-term if not lifelong treatment.
There are many factors contributing to weight gain and no treatment is going to work for everyone. Some may do well by simply making important changes to their lifestyles, some may need more intensive behavioural treatments, some may need medications, some may require surgery.
For some, the best they can realistically hope for is to stabilize their weight – i.e. stop gaining more weight every year.
For others, treatments may be more effective achieving 5, 10, 15 or even 20% weight loss that they may be able to keep off in the long term – but only if treatment continues. Stopping treatment will lead to relapse, or weight regain.
Tough words – tough decisions. No hope for cure, but certainly treatments that work and can effectively help manage weight and relieve comorbidities, i.e. if they stick with it.
No quick fixes, no magic pills, no miracle surgery and most of all – no false promises!
But also no blame, no pointing the finger, no sermons, no patronizing.
Just empathy and sound medical advice – the best we can offer!