Source / Disclosure
Karli Burridge, PA-C, MMS, FOMA, He is a board-certified medical assistant and a fellow of the Obesity Medical Association. Burridge received a certificate of higher education in obesity medicine in 2017. She is the PA President of Obesity Medicine and a board member of the Illinois Obesity Association. She is the founder and owner of Gaining Health, developed to help providers and organizations initiate or optimize obesity management programs.
Disclosure: Burridge reports that he is a consultant for Bariatric Advantage, Currax Pharmaceuticals, Gelesis, and Novo Nordisk, and a speaker bureau for Currax and the Obesity Medical Association. She is also the owner of Gaining Health.
From discreet stethoscopes to the most sophisticated gene editing techniques, today’s healthcare professionals have an amazing range of tools at their disposal.
But perhaps the most powerful tool for primary care providers is their oldest, their language.
A widely cited review of physician-patient communication conducted by Jennifer Fong Ha, MBBS (Hons) Dip Surg Anatto, And Nancy Long necker,PhD, Both the University of Western Australia have found that effective communication between providers and patients is essential to achieving quality healthcare. And this is nowhere more important than when brooching sensitive subjects such as obesity and overweight.
According to the Obesity Medical Association (OMA) Obesity affects over 236 other medical conditions.. However, most clinicians spend time treating obesity complications, ignoring the underlying causes of these complications, excess lipopathy and metabolic dysfunction. By treating obesity directly, providers can improve or resolve complications that are already occurring (often with lower dosages). Even better, you can prevent the onset of these complications from the beginning.
I argue that the current model of treating obesity complications, ignoring the root cause, is not sustainable. It does not improve the patient’s health and quality of life sufficiently.
It’s time for healthcare providers to be educated about obesity and start treatment like any other condition. Treatment of obesity may include the use of anti-obesity drugs or other evidence-based treatments such as weight loss surgery and devices to aid in lifestyle changes. This should start with a conversation that uses a patient-centric language. There are some considerations to keep in mind before you start.
Weight conversations should start with caution and respect
Choosing the right time and situation is important when starting a conversation about obesity with a patient.A good opportunity to discuss weight is during an annual physical or physical examination, or Medical conditions affected by obesity, Type 2 diabetes, hypertension, dyslipidemia, polycystic ovary syndrome, obstructive sleep apnea, GERD, arthralgia, or many other medical concerns.
However, it is important not to immediately attribute the patient’s complaint to weight. Instead, the clinician should evaluate his condition as he would for a normal weight patient. For example, if a patient complains of knee pain, we will provide regular care for this complaint, such as ordering the required images. Ask about potential causes or triggers of knee pain before assuming that the cause is obesity or overweight.
If the complaint is thoroughly investigated and found to be likely due to overweight, the provider can politely ask the patient if he or she is ready to discuss weight.Explain it without blaming or embarrassing the patient Weight control is much more complicated Rather than “reduce the amount of food you eat and increase the amount of movement”. At this point, you can offer to provide evidence-based assistance, and if the patient agrees, you can schedule a follow-up to discuss your weight specifically.
Engage patients with motivational interviewing techniques
Research suggests Engaging patients as health improvement partners can be effective in promoting weight loss. Patients need to feel empowered with respect to their health, and engaging in conversations with the provider plays an important role in this.
If you don’t ask the patient what the barrier is and give advice without asking for a possible solution, the provider feels that they don’t understand the patient’s situation or needs, or even worse, and therefore actually Can’t help the patient. Instead, motivational interviewing techniques, such as asking free-form questions instead of yes / no questions, can help patients feel more positive when discussing their health.
These free-form questions allow patients to express their thoughts and inferences. This gives providers more insight into the patient’s perspective. However, for this to work, healthcare providers need to take the time to listen to their patients. The healthcare provider may be a medical specialist, but the patient is his or her own specialist. And if they are part of the decision-making process, they are much more likely to follow the advice than they are told what to do.
5 Tips for Opening Effective Conversations with Patients
Ask for permission
The first step a healthcare provider can take is to seek permission to discuss a health topic, especially if it is a topic that may be sensitive to the patient. For example, the provider can say: “Nutrition plays an important role in diabetes management. Is it okay to discuss your nutrition today?” By asking for permission, healthcare professionals can take the patient’s autonomy when discussing their own health. And show respect for the agent.
Respect the patient’s reaction
If you do not allow the patient to talk about a particular topic, the provider must respect that decision. Providers may offer patients additional resources on the topic and offer to reassure the patient that the door is open whenever they are ready to discuss the topic. If the patient gives permission, the provider will need to use the motivational interviewing again and ask free-form questions. For example, a provider can ask, “How does weight affect health and quality of life?” Or “What do you think about your alcohol consumption?” The tone should convey empathy and a true desire to help the patient.
Avoid giving instructions
When it comes to driving changes in health behavior, especially with complex behaviors such as diet and physical activity, healthcare providers need to avoid the “righting reflex” that tells patients what to do. Instead, they should try to involve the patient in the decision-making process and come up with possible solutions. If the patient is not thinking about anything, the provider can offer two or three options and let the patient decide which one seems best. Once the decision is made, the provider needs to summarize the plan and ensure that the patient is confident in their ability to follow through.
Pay close attention to the words you use
The words used to discuss obesity are very important to avoid “fat shame”. In general, practitioners should not label patients for their illness, but instead use human-first language. For obesity, this means using phrases like “obese person” or “obese affected person” vs. “obese person”. The Obesity Action Coalition has created a very helpful one-page handout on the use of people-first language for obesity. You can access this. Here..
Rethinking the diagnostic language of obesity
Medical professionals use the diagnostic term “obesity” to recognize this as a disease. However, patients may be reluctant to use the terms “obesity” and “illness” because of the prejudices and prejudices associated with these terms. Consider using terms such as “weight,” “overweight,” and “increased BMI” when starting a weight conversation. Focus on the health debate and consider using terms such as “chronic condition” and “illness.” When educating patients about the complexity of weight and appetite regulation, it is easy to get into the diagnostic term “obesity”. You can also ask the patient which word or term they prefer and admit that obesity and weight management are associated with prejudice and prejudice.
Above all, keep in mind that patients are not due to their weight. Obesity is a complex condition with many causes, many of which go beyond lifestyle choices. Nevertheless, many patients internalize weight bias and blame obesity. Patients often avoid bringing up painful topics to their donors, as they feel that managing their weight is entirely their responsibility.
For the first time, patients can probably feel reassured and hopeful when the provider informs the patient that there is much more to manage obesity than simply eating less and moving. And this helps patients take the first step on their journey to better health.
Want to know more about how to treat obesity for a lifetime?The· Autumn Meeting of the Obesity Medical Society, September 23-26, is a major medical conference that provides clinical education to healthcare providers on how to effectively personalize obesity management in patient populations. This year’s conference is not only face-to-face, but also has virtual options.Registration Here.. And to stay ahead of the era of obesity prevention, treatment and reversal Become a member Of the Obesity Medical Association.
Obesity Behavior Association. People first language for obesity. https://www.obesityaction.org/wp-content/uploads/1033162_FirstPersonOne-Pager01_041921.pdf.. Accessed on June 14, 2021.
Obesity Medical Association. What is obesity? https://obesitymedicine.org/what-is-obesity/.. Accessed on June 14, 2021.
Obesity Medical Association. Diseases related to obesity. https://obesitymedicine.org/diseases-related-to-obesity/.. Accessed on June 14, 2021.
Obesity Medical Association. What Causes Obesity? https://obesitymedicine.org/what-causes-obesity/.. Accessed on June 14, 2021.
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