The Interaction Between Doctors and Patients in the Fight Against Obesity
What we have here is one of those good news/not so good news situations. I’ll give up the good news first.
The American Heart Association, the American College of Cardiology, and the Obesity Society have introduced a series of guidelines that doctors can use to treat obese or overweight patients. Among the recommendations are instructions to calculate the body mass index of patients at least one time per year and the possibility of advising weight loss surgery for patients who have a body mass index of 40 or more.
Now for the not so good news. Only forty percent of patients state that their doctors have suggested they lose weight although physicians themselves claim to make conversation about weight issues.
Why Is There Such Little Conversation?
Why is it that doctors are so hesitant to talk to their patients about weight issues? Well, doctors are people too.
Some doctors maintain that their patients do not like making conversation about their weight because they find the conversation to be upsetting. Simply enough, doctors do not want to hurt the feelings of their clientele.
Doctors also report that when they do raise the subject of weight, patients are indifferent about the information.
Because we have become less judgmental about weight issues as a society, it may be that doctors are equally on board regarding sensitivity and do not wish to risk insulting patients.
A second reason is that doctors are uncertain as to how to begin the conversation. Most primary care physicians do not have training in nutrition or weight management.
Perception As An Obstacle
A new study by John Hopkins researchers showed that obese patients who believe that their doctors are critical of their weight are more likely to attempt to lose weight but less likely to succeed. Patients often feel judged when such conversation was made.
An Internet-based survey showed that 14% of participants who felt judged and discussed weight loss with their doctors lost 10% or more of their body weight while 20% who did not feel judged and discussed weight loss took off the same amount of pounds.
New Guidelines and Engaging the Patient
Beyond calculating a patients body mass index on a yearly basis and making recommendations for patients who have a body mass index of greater than forty, the new guidelines suggest helping to develop a weight loss program that includes exercise and calorie-cutting as well as referring patients who have the potential for heart problems to weight loss programs.
Recommendations for successful communication are beginning the conversation in a non-judgmental way, assessing the patients readiness for change, forming a partnership with the patient, letting the patient know you are available, making a plan, and supporting the patient through regular interactions.
Physicians should also be empathetic, confident, humane, personal, forthright, respectful and thorough.
Living life well-fed,
My Bariatric Life
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