Pay Attention

Better Outcomes If You Pay Attention to People

Maybe good clinical care for people with obesity really is simple. Lawrence Cheskin of Johns Hopkins laid it out there in the midst of a session on treatment of severe obesity:

“The more you pay attention to people, the better they do.”

This epiphany comes from the American Society for Nutrition’s annual conference on Advances & Controversies in Clinical Nutrition. The best part is, he had data to back it up. In a study of text messaging for weight management in underserved adults, Cheskin showed that engagement was highly predictive (p=0.003) of greater weight loss at 6 months.  Every time they responded to a person in their study, that person’s weight loss went up by 0.04 kg. The words of their responses, quite literally, carried significant weight.

As if to underscore this point, the next presentation was by Patty Nece, providing a personal perspective on living with obesity from an early age. To illustrate how healthcare professionals may not pay attention to people with obesity, she told of an encounter with an orthopedic surgeon who diagnosed her as having “obesity pain.” “Let’s cut to the chase,” he said. “You need to lose weight.”

Now the fact was, she had lost a hundred pounds. Her real need was for a more competent clinician to pay attention to her clinical need, make a real diagnosis, and provide some clinical care for an orthopedic condition. Nece found that from another provider.

But her experience illustrates the sad fact of how pervasive weight bias interferes with providing good clinical outcomes for people with obesity. Rebecca Puhl of the Rudd Center for Food Policy and Obesity followed Nece’s presentation with an excellent presentation of the data on just how pervasive and harmful such weight bias is.

The answer is deceptively simple. For better outcomes in obesity, healthcare professionals simply need to pay attention to the needs of those affected.

To read an abstract of Cheskin’s study of mobile messaging for underserved adults with obesity, click here. If you happen to be curious about the patent for this technology, click here.

Pay Attention, photograph © Maciej_ie / flickr

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