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When it comes to myths surrounding obesity, the list of misconceptions is as long as the myriad of complications it can cause.
When it comes to myths surrounding obesity, the list of misconceptions is as long as the myriad of complications it can cause. Obesity treatment consists of four pillars: Nutrition, physical activity, behavioral counseling and pharmacotherapy. In honor of National Nutrition Month, let us focus on the important role nutrition counseling plays in effective obesity treatment plans. When patients are supported by their health care providers with personalized, evidence-based guidance, outcomes significantly improve.
The first step in treating patients with obesity is broaching the subject, which can be difficult for a spectrum of reasons. Common barriers, which can be real or perceived, include a lack of education about obesity and its treatment, weight bias, lack of knowledge about effective communication strategies, time limitations, reimbursement challenges, fear of making patients uncomfortable, and the assumption that patients aren’t motivated to address their obesity.
As clinicians, it is vital that we bring up the topic of obesity, because patients don’t receive treatment if it is not discussed. Research indicates that patients want their providers to broach the topic.1 Most importantly, helpful conversations about obesity are the gateway to effective treatment and improved health.
It’s important to understand common obesity myths that your patients—and other healthcare providers—may believe to be true. Here are three common misconceptions about nutrition and obesity:
Obesity is caused by overeating
Normal life can resume once obesity is resolved
Weight gain or loss is solely determined by calories
Initiate obesity conversations
With misconceptions like these, it can be intimidating for patients to have these conversations so it’s important to remember that broaching the topic of obesity with patients begins with gaining permission. Consider the following phrases: “Do I have your permission to discuss your weight?” “Would it be alright if we discuss your weight?” and “Do you have any concerns about your weight?”
Once the patient has granted permission, focus on building a respectful and collaborative partnership. When patients feel that a clinician is on their side, they are much more open to discussing weight and treatment options. The goal of the conversation is to set the stage for further conversation and assess the patient’s readiness for treatment. When patients are not ready, revisit the topic at a later date and invite them to return when they are ready.
Encourage nutritional strategies
When creating a treatment plan for patients with obesity, implement nutritional strategies in increments. It is easier to be successful when eating changes are done one step at a time. Here are some important nutritional elements to discuss with patients:
Recommend nutrition resources
Evidence demonstrates that tracking is associated with weight loss. Tracking can identify indulgences that aren’t remembered, reveal skipped meals, or highlight snacking habits that lead patients to be overly hungry and vulnerable to eating convenient processed carbs and/or overeating. Suggesting ways for patients to track eating habits can be helpful, such as apps, spreadsheets and notebooks.
While wearables can be effective for monitoring physical activity, such as daily step counts, tracking methods that focus on calorie deficits can be problematic. If a patient has expended energy through exercise, the app may tell the patient that they can consume a specific number of calories and still lose weight. This is rarely the case and can lead to indulging in ultra-processed foods that increase insulin and inhibit lipolysis. It is better to use tracking to monitor intake and review the information with the clinician or dietician, who can assess the effectiveness of the eating plan.
For more effective strategies to help patients with obesity, consider joining the Obesity Medicine Association (OMA). Members gain access to a trove of resources designed to educate and empower health care professionals with advanced obesity medicine knowledge.
To learn more about OMA or to become a member, visit: www.obesitymedicine.org.
Sandra Christensen, MSN, ARNP, FOMA, is a board-certified nurse practitioner and has specialized in obesity treatment since 2005. She owns Integrative Medical Weight Management in Seattle, Washington, where she provides personalized, comprehensive obesity treatment. She is a fellow of the Obesity Medicine Association, serves on the Board of Trustees, and holds the Certificate of Advanced Education in Obesity Medicine.