Assessment

Patient Expectations

The expectations that patients have about achieving weight loss are influenced by their past experience, what they read/see in the media, and others around them including healthcare professionals. Expectations are often greatly inflated beyond what is achievable from a physiological and psychological perspective. In addition to patient expectations, healthcare professionals need to ensure that they do not place unreasonable demands on their patients with regard to achieving weight loss. It is not uncommon to have obese patients report that their place on a surgical waiting list has been suspended until they can lose 4–5 stones in weight, yet they are expected to achieve this without any support being offered?

 

Assessing the expectations that patients have about weight loss requires a careful and considered approach. A good place to start is by asking patients what losing weight means to them this time. Ask patients to list everything that they think would change if they lost weight. Are all of these things really dependent on weight loss or could some of them happen even without losing weight e.g. taking a holiday or taking up an evening class? Check what impact they think weight loss would have on their health and provide information on the benefits of even small amounts of weight loss.

Discuss the long-term and short-term goals for weight loss with a patient. In doing this, remind patients that just as with many other activities in life, losing weight requires effort, skill and determination. Encourage the patient to consider if they would have the same expectations of themselves if they were to decide to change other areas of their life? For example, would they be happy with anything less than the perfect garden if they decided to take up gardening as a hobby? Would they expect to achieve this as a matter of course or would they know it was dependant on a number of other factors such as the time they could devote to this, the information they would gather from books or magazines, advice from other gardeners, the money available for this, their level of motivation and the current condition of the garden. The approach to weight loss should not be any different to how we manage change in other areas of life. Individuals need to start with small steps and require help and support to formulate a plan, which will ensure that they will achieve a worthwhile but realistic level of weight loss.