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Department of Family Medicine
Health Promotion: Weight Loss
300,000 people die annually due to
poor diet and inactivity
How can you encourage your
overweight patients to lose weight?
Many patients are not aware of the long-term impact their weight may have on
their health. We are surrounded by media messages advocating thinness for beauty
and popularity reasons, but the message that weight is related to health and
wellness and therefore, quality of life, is not as widespread.
Every office visit is an opportunity for your patient to be
reminded about the connection between weight and wellness.
Review the Transtheoretical (Stages of Change) Model in the Tool
Box. Match the intervention to the patient's readiness to
change.
Raising Awareness
Discuss the connection between a healthy lifestyle, including desirable
weight, and lower risk for chronic illness as we age. Identify diseases that are
believed to be related to obesity. The American Diabetes Association's website
provides a risk assessment for developing diabetes.
Use a systems approach to healthy weight in your practice. The message should
be consistent from all staff, from the time the patient enters the waiting room.
Consider a weekly weigh-in time when patients can come in without an
appointment to be weighed, have BP checked.
Body Mass Index (BMI) is a popular assessment method. The BMI number
indicates the patient's health risk due to being overweight.
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Hang a BMI chart over your scales
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Have nurses help patients identify their BMI and
understand what it means
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Computer-literate patients may want to visit the
ShapeUp America website which provides BMI
calculations
Giving Information
Talk about weight loss and a healthy diet.
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Take advantage of opportunities during the
office visit to ask patients about past dieting attempts. Encourage those
who have dieted in the past and regained to try again, making dietary
changes they can incorporate into their lifestyle. Visit the National
Institutes of Health, National
Institute of Diabetes and Digestive and Kidney Diseases website for
information debunking the commonly-held belief that weight cycling is
harmful.
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Offer to assist with patient education,
provision of diets, food pyramids.
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For patients concerned about hunger as they
reduce intake, emphasize eating 5 small meals per day.
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Address patient's concerns about difficulty of
changing eating behavior. Acknowledge that it is not easy, but you will
support them in their efforts.
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Patient may focus on reasons not to change; help
them identify pros for changing eating behaviors.
New Vision
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Encourage patient to visualize the new,
healthier person they could become. They need to see themselves differently,
imagine what their life could be as they change both physically and
psychologically.
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Emphasize the benefits of combining calorie/fat
reduction with moderate exercise.
Behavioral Plan
When patient is in preparation, develop a behavioral plan for weight loss.
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Baseline assessment–Have patient keep a food
diary for several weeks, identifying caloric intake, fat, cholesterol.
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Stimulus control–encourage patients to
identify environmental changes they can make to help them succeed, i.e., get
rid of high calorie snacks and desserts, no eating in front of TV.
Substitute positive behaviors like exercise or relaxation for unhealthy
eating behaviors.
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Set reasonable goals focusing on small amounts
of weight loss.
Reinforcement
When the patient is in the action stage
- Use positive reinforcement in the form of praise, recognition. Have
patient identify ways to self-reward for results.
- Social support in the form of support groups, family and friends may be
helpful.
- Clinician-provided social support–occasional phone calls from staff,
office visits to check progress
- Relapse prevention–Help patient learn to identify mistakes as lapses,
not total failure. Many patients will need a cognitive re-framing of
mistakes–a change from "I've blown my diet" to "I made one
mistake; that does not mean I have failed."
Contact Information
Dr. Peggy J. Wagner
Research Director
Email: pwagner@mcg.edu
(706) 721-7589 |
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