Healthcare professional

Resources and training to support healthcare professionals

Lifestyle


Advice and support to help you and your family

Raising the issue

Attitude towards obesity

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Published on Tuesday, 13 June 2006
There is no escaping the fact that many people feel uncomfortable in both raising and discussing the issue of body weight. Society’s view of overweight and obesity is generally very negative and many worry that raising the issue of a person’s weight could be interpreted as a comment on the individual’s personal appearance. The prejudice that surrounds obesity also leaves many patients reluctant to seek help for fear of being made to feel ashamed. Healthcare professionals need to examine their own attitudes and beliefs towards obesity and to consider how best to broach the subject of weight management with individual patients.

 

In Practice

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Published on Tuesday, 13 June 2006

Obesity is an important health concern that needs to be raised in a sensitive, open and empathic manner:

 

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Establishing Patient Interest

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Published on Tuesday, 13 June 2006
Listening carefully to the response given by patients when invited to consider a weight management programme will provide insight into their ability and commitment to lose weight. Often we say that patients need to be ‘motivated’ to lose weight but this is not something that is easy to assess. As discussed by Kushner & Pendarvis (1999), motivation is an internal state that the patient expresses verbally and behaviourally, but declarations of intent may not accurately reflect the true capabilities or commitment of the patient to make changes.1

 

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Lack of Patient Interest - brief intervention

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Published on Tuesday, 13 June 2006
Do not always expect patients to express an interest in entering a weight management programme. The level of knowledge, concern for health, confidence and ability to overcome difficulties will vary among individual patients and some may justifiably decide that attempting to lose weight at this time is not practicable.

The most suitable strategy at this point is to ensure that the door is left open to revisit this discussion at some point in the future. Increase understanding of the health risks associated with obesity and encourage the patient to minimise any further weight gain. Make a record of the discussion about weight management in the patient’s notes to prompt a review of this and to ensure that other members of the team are aware that this has been broached with a patient. The approach should at all times be supportive.

Patient Interested - brief intervention

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Published on Tuesday, 13 June 2006
If the patient expresses interest in proceeding with a weight management programme, a number of options can be explored which could include: exercise referral, a self-help programme, a commercial slimming club or other group programme. Regardless of option chosen, it is important that baseline data (such as: BMI – height and weight measurements, waist circumference, blood pressure, blood glucose, blood lipid levels) are recorded for future monitoring, audit and evaluation purposes. If a decision to treat within the practice is taken, it is important to have in place a protocol, which clearly outlines the management process. The first step should be a thorough and detailed assessment, so that the intervention can be matched to individual needs.

 

Discussing Options

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Published on Tuesday, 13 June 2006

The public preoccupation with body weight means that there is no shortage of individuals or groups offering the ‘ultimate’ treatment for weight loss. In fact, this is what separates obesity from all other health related conditions. The slimming industry is highly lucrative, and every year billions of pounds are spent by consumers on expensive slimming products that promise to make weight loss an effortless experience. With so many mixed messages provided to the public and with so much focus on the aesthetic aspects of weight loss, it is necessary to be very clear about the purpose of embarking on a medically directed weight management programme.

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Non-NHS Routes

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Published on Tuesday, 13 June 2006

Commercial slimming clubs

The content and structure of slimming clubs vary, but in general they offer support in the form of a weekly group meeting, they follow a particular food plan and have a membership and/or attendance fee. Typically, group leaders are previous members who have personal experience of using the plan to lose weight. The most well known UK commercial slimming clubs include:

 

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Popular diets

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Published on Tuesday, 13 June 2006
Diet books are rarely off the top ten best-sellers list and their appeal is understandable. They are frequently celebrity endorsed, promise a new and unique approach and often provide compelling accounts of personal success stories. The eating rules of popular diets are generally the most novel aspect of the diets, rather than their scientific basis, as is often claimed. The most popular diet books include:

 

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Internet-based Programmes

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Published on Tuesday, 13 June 2006

The internet is a popular medium of communication and source of information on all aspects of health, including obesity. Access to the worldwide web has increased and as such has created new potential in terms of delivering patient healthcare.10 Several research centres have evaluated the potential of using an internet-based weight management programme 11-13 with mixed findings in relation to the use of the internet as a medium for facilitating long-term weight maintenance.14,15 Research in this area is relatively limited at present, but the possibilities for healthcare professionals to use this as a medium for delivering structured programmes and supporting patients has enormous future potential.

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Monitoring Patients who follow a Non-NHS Route

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Published on Tuesday, 13 June 2006

Patients who are following a non-NHS programme for weight management will feel more supported and possibly more motivated to continue with a programme if they feel that their healthcare providers are taking an active interest in their progress. This does not necessarily mean that a formal review appointment has to be arranged as this could be discussed with the patient when attending other routine appointments. Some practices do offer brief ‘drop-in’ sessions for patients to enable them to update their healthcare professionals. This also allows practitioners to carry out a more comprehensive assessment of progress e.g. blood pressure changes or blood lipid changes. As the management of obesity is a lifelong process it is likely that some patients will chose to dip in and out of non-NHS programmes. The primary healthcare team can therefore provide consistency in terms of support and monitoring and can continue to guide people through the options for weight management in a patient-centred way.

The Assessment and Treatment modules provide a comprehensive review of the assessment procedure and treatment options for patients for whom it is more appropriate to treat via the practice or another NHS route.

References

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Published on Tuesday, 13 June 2006

Please click "Read More" to view the references for this section.

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