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Establishing understanding about obesity |
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The patient must be given the opportunity to describe what has led to their weight increase and it is also important to discuss previous weight loss attempts (and their success/failure). Listening to a patient’s account of the factors that have contributed to their weight gain will help to establish their understanding and beliefs about obesity With patients who are convinced that their weight gain is out of their control (e.g. due to perceived genetic or metabolic influences) health professionals should recognise that this needs careful exploration.
There is probably little to be gained from trying to openly challenge the patient who is adamant that they eat very little and still seems to gain weight. A more productive approach may be to acknowledge that obesity is a complex condition which has many contributory factors and that by carrying out a thorough assessment a better picture of the changes which would help them to lose weight may be established. Practitioners can also offer information on what is known about genetic influences and how metabolic rate is inevitably increased with obesity in a very neutral manner. People often compare themselves to others e.g. a partner or colleague without taking into account the differences in energy requirements between males and females, or the impact that physical activity has on helping people to maintain a lower body weight. It is only with time and by building trust and rapport that patients may feel more ready to address the causes of their weight gain.
It is also important to establish the patient’s understanding of the health risks associated with obesity, even though this may already have been discussed when the issue of body weight was originally raised with the patient. Many people are becoming more aware of the links with diabetes and heart disease but the links with conditions such as cancer, osteoarthritis and, in particular, sleep apnoea may be less well recognised.
The Raising the Issue module provides further guidance on talking to patients about their weight.
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