DIY Obesity Care, Self Blame, and Quality of Life

Two new studies in Obesity point to a big opportunity lost for people living with obesity. Professional help with obesity can offer significant improvements in quality of life. And yet, 90% of the people who could benefit don’t get that help. DIY obesity care is the dominant strategy.

DIY Obesity Care

Andrew Stokes and colleagues analyzed data from NHANES to get an idea of the choices people are making to do something about obesity. The dominant approach is self-help. More than half of all people with obesity (51%) try to lose weight on their own with no help from any health professional. Most of the rest either do nothing (30%) or see no problem (9%). Only ten percent seek help from any health profession and only four percent consult a doctor.

This research puts hard numbers on a familiar problem. Health professionals, for the most part, are simply not engaged in providing obesity care in any form. Part of the problem is financial. Health plans have been slow to pay for obesity care. Part of it is skills-based. Most health professionals lack the skills to provide the necessary care.

But the worst part of the problem is fat shaming. Anti-fat bias among health professionals remains strong. When the subject of obesity comes up, patients feel shamed and blamed. Helpful care is rare.

Missed Opportunity

DIY obesity care leaves people to try an endless parade of diets. It produces short-term weight loss, followed by regaining all of that weight in most cases. It leaves people feeling worse and worse about themselves.

But the second study, by Rebecca Pearl et al, shows that something as simple as intensive behavioral support can yield real improvements in the lives of people with obesity. People in this study lost, on average, a bit more than nine percent of their starting weight in a 14-week program. A year later they maintained most of that weight loss and enjoyed a significantly better quality of life.

People could function better physically. They felt better about themselves and experienced less depression. Interestingly, public distress (e.g., embarrassment related to weight) went down, but the effect was gradual. Unlike other measures of life quality, this dimension took time to improve.

Why this missed opportunity? As we’ve said, you can find many reasons. But what’s important is to realize that, even with simple measures, we can do better.

Click here for the study by Stokes and here for the study by Pearl.

Happy Weekend! Photograph © Scholastica / flickr

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April 30, 2018