Empathy and Weight Loss

Obesity is linked to many serious medical conditions. Yet many physicians refrain from talking about "the elephant in the room" for fear of offending patients. 

The Archives of Internal Medicine published a study with the conclusion: "[P]atient reports of being told by a physician that they were overweight were associated with more realistic perceptions of the patients’ own weight, desire to lose weight, and recent attempts to lose weight."

When in practice, I never hesitated to bring concerns about weight center stage. My approach reflected my unique role as expert guardian, guide, companion and/or cheerleader in patients' efforts toward optimal health.

"This is not a social visit," I'd begin. "I'm concerned about the 'you' inside your body; I care about your heart and joints and physical comfort, and not what size clothes you wear."

I would focus on which specific activities of importance to the individual patient would likely be compromised if the patient developed which specific medical complications. Rather than try to frighten patients into adopting more healthful lifestyle, I tried to motivate patients positively by linking the measurable outcome (i.e., current weight) to meaningful endeavors (e.g., ability to sit on floor with small grandchildren or to work in the garden).

I believe the best approach is one that addresses patients' unique needs, desires, strengths, weaknesses and circumstances at each phase of recovery. It's an approach that requires time, effort and caring about the life of each patient.

Conclusion: It takes time to deliver efficient care.

Comments

[Finn]

I'm not overweight but I think your approach would work with me. The only time I've intentionally lost weight it was to improve my race time and help me jump a little higher in tae kwon do.

I'm curious; how well did this approach work with your patients?

[Wendy S. Harpham, M.D.]

Patient's success varied. Some did very well, achieving goal weight and maintaining it. Those were joyful visits. These patients almost always adopted healthier lifestyle changes in many spheres, e.g., exercising, pursuing hobbies, etc.

Many patients improved, but didn't achieve goal weight before I retired (even if we'd been working on it for years).

Sadly, a few patients never improved or they continued to gain.

Hope this helps, Wendy

[Donna M]

If only more physicians took your caring approach to the subject of obvious overweight in a patient. Most MD's and other health professionals assume you, of course, KNOW that you need to lose weight, and are just not ready or able to do it. They may say "you need to lose weight." But your explanation of the benefits to the insides of the body, and the activities one will be able to do I have never personally encountered an MD address with me (and I was overweight my entire life). Kudos to you, and may others who read your blog get the hint!

[Jan Hasak]

This is so true. Obesity will soon overtake cancer treatment as the leading cause of lymphedema, I learned recently from some National Lymphedema Network experts. That's another angle to motivate the patient: lose weight to keep the swelling from becoming permanent and possibly life-threatening. My hope is that more doctors will take your caring stance on this serious lifestyle epidemic in the U.S.

[Krout Etheridge]

This post is very informative. It's a great help. Thanks for sharing!