Target the obese patient and family follows too!

The HealthGal Health Guide
  • Research studies have recently explored whether obesity is "catching." The conclusion was that if you have a lot of family and friends who eat a certain way and rarely exercise, that can become the "seducing norm" for you, meaning you too begin to eat a certain way and ignore fitness. Studies also looked at the impact of social networking on a person's size, and again concluded that certainly the individuals who surround you typically impact your decisions, which can also include how much and what you eat on a regular basis and whether or not you choose to be fit. Certainly text messaging can "push" you to be a better dieter and exerciser because consistent reminders do help us stay committed to goals we set.

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    A recent study looked at a group of obese people who chose to use cognitive behavioral therapy or CBT as a means to lose weight. This type of therapy is considered an important tool for battling the bulge because it focuses on changing people's thoughts and attitudes in relation to their eating and lifestyle patterns. This type of therapy also makes recommendations that help patients stay on track with their weight goals, for example keeping a food and exercise diary daily, and finding alternative behaviors when they feel an overwhelming craving. Italian researchers conducting the study also wanted to see if there was an "extended impact" from the CBT on family members. The program recruited 149 obese patients to the University of Bologna and CBT lasted for 12- 15 weeks.


    When researchers looked at the extended family members of these patients at the six month post-CBT time frame, they noted that on average, family members had shaved about 200 calories/day from their regular eating plans, and many of the family members were eating less fat and refined carbohydrates, and a bit more fruit. Most family members lost about 2 pounds, but the significant impact was mostly seen among obese relatives. They actually lost 6 pounds on average, and some lost enough weight to move from "obese" to ‘overweight" status. What really happened here?


    The senior researcher postulated that the family members may have decided to make changes at home to support and help the ongoing commitment of the obese patients, who were clearly determined to follow through on losing weight through CBT. Others have suggested that the CBT required the patients to make changes at home in terms of calorie counting, cooking methods, how they stock their fridge and pantry, what kinds of purchases they make at the supermarket, and so all this meal planning involved the food that everyone was eating at home. Healthy changes in the home affect all members. It should be noted that a recent small Stanford University study on gastric bypass patients also showed that family members were impacted positively "by association," though the overall benefits were small.


    The American Dietetic Association reviewed this Italian study and concluded that the study has some limitations. Though 500 patients had originally signed on, less than half participated, suggesting that commitment to CBT is not easy and it may have been the "most motivated patients" we are seeing and not a broad representation of obese people. CBT is often costly and not covered by insurance, making it less available to most obese patients. Italian families tend to be tight knit and often eat together, so it's not unexpected that healthy changes in the home affected family members other than the patient enrolled in the study.


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    Opinion: This study does further support that obesity is a family disease. That's why I wrote my book, The 4 Habits of Healthy Families, with the core premise that healthy eating and a commitment to exercise begins in the home, with parents modeling behaviors. It takes a "team" mentality to get everyone involved, even if each family member may have different goals.

Published On: November 28, 2011