OCW2020: Taking a Real View of Obesity Care

Let's Get RealLet’s face it. We live in a culture that is obsessed with weight and body image. Cool Sculpting ads bombard us with the promise to target, freeze, and eliminate inconvenient fat cells. To “take you further.” But this and other cosmetic nonsense has nothing to do with a real view of obesity care. The point of obesity care is health, not weight. It’s all about addressing the health implications of adiposity that’s harming health.

Losing weight can be a part of good obesity care. But sometimes it’s not. And it is certainly not the whole story. Obesity treatment is today’s focus for Obesity Care Week.

Patient-Centered Care

Because we live in a culture obsessed with body image, it’s almost impossible to ignore it. People offer unsolicited advice. (Of course, if you didn’t ask for it, it’s not advice.) Family, friends, and colleagues are surprisingly willing to pipe up when they have no business doing so. Some employers offer “incentives” for people to lose weight. None of this prodding, poking, or prying is especially helpful. It’s all about what somebody else wants.

Healthcare professionals – if they address it at all – most often merely instruct the patient to lose weight. As if that thought had never crossed the patient’s mind. Not helpful.

But real obesity care is all about meeting the patient where they are. It’s about understanding a patient’s health needs, goals, and challenges. That’s the underpinning of motivational interviewing. It’s the very essence of patient-centered care.

Real Obesity Care for Better Health

Good Obesity CareStepping back to take a real view of obesity care leaves weight loss buried in the details. Good care starts with self-care. It starts with stopping those other voices from telling you what you oughta wanna do. Replacing those voices is your own voice for what you want from health and life. If losing some weight is part of the picture, fine.

The real point, however, is to reduce health risks. HEB, a regional grocery chain in Texas, started offering full access to obesity care for its employees in 2018. By 2019, they saw a 28 percent reduction in the number of employees with five or more health risks.

Building on self care is professional lifestyle therapy. Most often that will come from a registered dietitian. But it can also be a clinical psychologist, a competent health coach, or another health professional who understands the physiology of obesity. If you have a primary care provider who understands obesity, they can connect you. If not, you’ll have to be more discerning and resourceful yourself.

However, lifestyle therapy is most often not sufficient to overcome the health impact of obesity. That’s when anti-obesity medications can help. A board-certified obesity medicine physician can be helpful. Surgery, too, can have a profound impact for improving health. Even so, surgery is not the end of care, but just a step along the way. Obesity is a chronic disease and ongoing care is important. The body ages, adapts, and changes.

Real obesity care adapts with your body and your needs. Seek it out.

Let’s Get Real, photograph © Obesity Action Coalition / OAC Image Gallery

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March 3, 2020