Understanding and Addressing the Challenge of Obesity in Clinical Practice

 
Obesity is Here to Stay and Not Going
Away: How to Discuss This Potentially
Sensitive Clinical Issue with Your
Patients
 
 
JEREMY CLORENE, PH.D.
 
Lead Psychologist
Advocate Weight Management
 
565 Lakeview Parkway, Suite 102
 
Vernon Hills, IL 60061
 
c 847-877-1331
 
 
An estimated 97 million adults in the
United States are overweight or
obese. That figure represents more
than 50% of the American adult
population. Of this group, 11 million
adults suffer from morbid obesity
(100 pounds over weight). CDC
 
Heart Disease Deaths
Each year, about 600,000 people die of heart disease
 (#1)
 
Heart Attacks
 
Per year 715,000 people in U.S. have a heart attack.
About 190,000 people who have survived a heart attack go on to
have another.
 
  
 
Nearly 8 million people in the United States (3%) have
 
had a heart attack.
 
Disability
 
Three most common causes:
 
arthritis or rheumatism (affecting an estimated 8.6 million persons)
 
back or spine problems (7.6 million),
 
heart trouble (3.0 million)
 
National Health and Nutrition Examination Survey
(NHANES),
 
WHY THE TREND?
 
1970’S “FAT FREE FALACY”
RESULTED IN MORE
CARBS/SUGAR (TASTE)
 
CARBS/SUGAR ARE YUMMY,
CHEAP, AND ADDICTING…AND
BTW…MAKES US FAT!
 
What does this mean?
 
Health decline, disability, financial
impact, social judgment, occupational
impact, discrimination, emotional
impact, interpersonal impact,
chronic negativity
(gender differences on many issues)
 
 
What is the Biochemistry / Physiology?
 
 
We love sweets, sweets, sweets
 
Also, Turning off of “full centers” in
  
the brain
 
Numbing all other feelings…
  
Sugar is the great anesthetic!
 
What is the psychology
?
 
CONVENIENCE...
 
 
"I want it easy"
  
Because the rest of my life
  
certainly isn't!
 
Who are we battling
?
Billion dollar corporations sole purpose is to get
you to eat…specifically to eat carbs/sugar!
 
-
McDonald’s, General Mills, Boston Market, Coca-
Cola, Mars, Kellog Co., Kraft Foods, H.J. Heinz,
Hormel, Ralcorp, Smucker’s, Sara Lee, Land O
Lakes, PepsiCo, Auntie Anne’s, Dean Foods, Ocean
Spray, Campbells, Smucker’s, Pepperidge Farm,
Frito-Lays, Hershey’s, Nestle’s…
 
 
OBESITY…
 
WHO’S FAULT IS IT?
 
 
Not our patient’s!!
 
 
But it is their problem
 
…and ours!
 
Obese / Overweight People...
 
STIGMA /
 
BIAS /
  
STEREOTYPES
 
Unfortunately multiple negative stereotypes...
 
lazy, sloppy, less competent, lacking in
 
self-discipline, disagreeable, less
 
conscientious, and poor role models.
 
Overweight employees may suffer wage penalties,
 
paid less for the same jobs,
 
more likely to have lower paying jobs,
 
less likely to get promoted than thin
 
people with the same qualifications
 
Medical Staff...plenty of bias against obese pts
 
physicians, nurses, psychologists, dieticians,
medical students...
  
less intelligent, unsuccessful, weak-willed,
 
unpleasant, overindulgent, and lazy.
 
No surprise obese patients may avoid obtaining
medical care because of these negative
experiences.
 
Research shows obese patients more likely to cancel,
delay appointments, avoid preventive health care
services, particularly among women.
 
DIETS
DIETS
DIETS
 
WHY DO WE CONTINUTE TO
GO ON DIETS?
 
 
 
 
Because Dieting actually works
You will have weight loss!!
Average dieter makes 4-5 attempts each year.
Successful diets last approx. 3 months and
people lose 6-15 pounds.
But most regain and more!
 
Then why, then, do we continue to
believe in dieting?
 
 
No matter how frustrating and hard the
process is...
  
Dieting gives us hope, hope, hope!
 
 
Dieting is seductive, intoxicating belief that
we are just one diet away from changing
our bodies, mood, confidence, health, lives.
 
THIS RESULTS IN…
 
 
ALL OR NOTHING THINKING
 
AND BEHAVING !!
 
 
I’m either avoiding the issue entirely
or jumping in all the way
 
WHAT DOES THIS MEAN FOR HEALTH CARE
PROFESSIONALS?
 
Pts have had negative experiences…stigma, no success
Pts have tried to lose many times without success
Complex issue and not simply about “Will Power”
Many factors contribute to weight gain and obesity
Understanding readiness for change is key
Can’t change “Lifestyle”…can change one behavior
Small, sustainable weight loss is big victory for health
 
 
 
PATIENT / STAFF
OBESITY BILL OF
RIGHTS
 
 
1. YOU WILL BE SUPPORTED AND
TREATED WITH RESPECT, NOT
INGNORED OR JUDGED.
 
 
2.
 MEDICAL STAFF WILL BE
ENDLESSLY PATIENT AND
APPROPRIATELY PERSISTANT.
 
 
3. THE MEDICAL TEAM IS A
POSITIVE RESOURCE FOR YOUR
WEIGHT MANAGEMENT
JOURNEY
 
 
 
4. THE FOCUS IS ON SUCCESSFUL
SUSTAINABLE BEHAVIOR
CHANGES
 
 
5. IMPROVING HEALTH IS THE
PRIMARY GOAL
 
Defined as: more active, less
medications, better health markers
such as lower weight, improved blood
pressure / blood sugars, and better
mood
 
 
WHAT TO SAY AND HOW TO SAY IT?
 
 
First…review “Bill of Rights”
 
 
Second…ask questions, let the patient talk…
  
They may be right!
 
 
 
"WOULD YOU OBJECT TO DISCUSSING YOUR WEIGHT
AND ISSUES SURROUNDING WEIGHT LOSS?"
 
"HOW READY DO YOU THINK YOU ARE IN
ADDRESSING THIS ISSUE?"
"WHAT HAS WORKED FOR YOU IN THE PAST?"
"WHAT WOULD YOU LIKE TO DO?"
"WHAT CAN WE DO TO HELP AND BEST SUPPORT YOU
IN THIS JOURNEY?"
 
 
"WHERE ARE YOU IN THE PROCESS OF YOUR WEIGHT
LOSS?"
"WHAT DO YOU FIND MOST DIFFICULT IN LOSING THE
WEIGHT?"
"WHAT DO  YOU FIND MOST DIFFICULT IN KEEPING THE
WEIGHT OFF?"
"IF THERE IS ONE BEHAVIOR YOU WOULD WANT TO
CHANGE WHAT WOULD IT BE?"
"WOULD YOU OBJECT IF I MADE SOME SUGGESTIONS?"
"WOULD YOU OBJECT IF WE CONTINUE THIS DISCUSSION
WHEN YOU RETURN FOR YOUR FOLLOW-UP?"
 
KEYS FOR PROVIDERS:
 
BE COMPASSIONATE
STAY PATIENT
BE PERSISTANT
EXPECT SUCCESS
BE POSITIVE
BE REALISTIC
…REPEAT…
 
Goals today:
 
1. Frame and better understand the problem -
  
Obesity: Serious health issue that is not
 
going away weight management is a
 
complicated behavioral, medical, and
 
personal journey.
 
 
2. Develop some techniques to better
 
communicate with our patients -
  
Tone is about respect
  
Ask questions first, suggestions after
 
QUESTIONS?
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Discussing the sensitive clinical issue of obesity with patients is crucial, considering its significant impact on health, including heart disease and disability. Addressing the root causes, such as dietary trends and lifestyle habits, is essential in promoting healthy weight management strategies and fostering open dialogue with patients.


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  1. Obesity is Here to Stay and Not Going Away: How to Discuss This Potentially Sensitive Clinical Issue with Your Patients JEREMY CLORENE, PH.D. Lead Psychologist Advocate Weight Management 565 Lakeview Parkway, Suite 102 Vernon Hills, IL 60061 c 847-877-1331

  2. An estimated 97 million adults in the United States are overweight or obese. That figure represents more than 50% of the American adult population. Of this group, 11 million adults suffer from morbid obesity (100 pounds over weight). CDC

  3. Heart Disease Deaths Each year, about 600,000 people die of heart disease (#1) Heart Attacks Per year 715,000 people in U.S. have a heart attack. About 190,000 people who have survived a heart attack go on to have another. Nearly 8 million people in the United States (3%) have had a heart attack. Disability Three most common causes: arthritis or rheumatism (affecting an estimated 8.6 million persons) back or spine problems (7.6 million), heart trouble (3.0 million)

  4. National Health and Nutrition Examination Survey (NHANES),

  5. WHY THE TREND? 1970 S FAT FREE FALACY RESULTED IN MORE CARBS/SUGAR (TASTE) CARBS/SUGAR ARE YUMMY, CHEAP, AND ADDICTING AND BTW MAKES US FAT!

  6. https://encrypted-tbn1.gstatic.com/images?q=tbn:ANd9GcTnZa6v7b-_UDFL-lHlBfNZDW2WOmpeJwIE7yvc03S2agHJM4aFhttps://encrypted-tbn1.gstatic.com/images?q=tbn:ANd9GcTnZa6v7b-_UDFL-lHlBfNZDW2WOmpeJwIE7yvc03S2agHJM4aF

  7. https://encrypted-tbn3.gstatic.com/images?q=tbn:ANd9GcSwGj9_9rU9NkNtxA4n_1qT8kNgmJheFSkPj9NGxgb2tm_cuip5https://encrypted-tbn3.gstatic.com/images?q=tbn:ANd9GcSwGj9_9rU9NkNtxA4n_1qT8kNgmJheFSkPj9NGxgb2tm_cuip5

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