As one of the authors of the ACTION-IO study, I was asked to present on the study findings to an audience of medical doctors from around the world.
On average there was a delay of 6 years from when people with obesity (Pw0) first start to struggle with their weight, and when they first have that initial discussion with a health care professional (HCP).
The most common reason for this delay was that PwO believe that their weight is their responsibility.
In this time period, the majority of PwO are attempting a mean of 4 weight loss attempts via commercial or other weight loss methods.
This shows they are motivated and care about the impact that their weight has on their health. It also supports that they are motivated!
The 3 key messages I delivered were:
- As doctors, we should lead by example:
- eg band the “f” word in our clinics/hospitals …I’m referring to the word “failure” (people with chronic disease will either respond or not respond to a particular therapy)
- use people first language eg person with obesity, not an obese person
- We need to increase education about the science of obesity
- 60% genetic predisposition (which we can’t do anything about); the rest is environmental lifestyle factors (what is consumed, physical activity, sleep, stress, medications, certain illnesses etc which we have some control over)
- As health care professionals, to be proactive in managing people with overweight or obesity
- start the conversation
- make a formal diagnosis of obesity: discuss with the patient, put the IDCC code in their electronic notes
- start management earlier rather than later; this includes arranging follow-up &recall
Other themes that arose from this meeting were:
- Feel confident /reassured that its ok to raise the issue of weight with your patients during the consultation, within minimal fear of offence; as long as it’s done in a sensitive and non-judgemental manner.
- Patients with chronic diseases do better ie better control of their health condition and less frequent and/or less severe complications if they actively manage their health condition
- Don’t tell patients what to do; empower them to do it themselves
- And remember, you’re only expected to deal with one problem at a time.. continuous incremental work on a chronic lifelong health condition
- More education is required globally, so that there is a better understanding of the role that genetic predisposition plays (estimated approximately 60%)
- More education is required about the body’s hormones which control appetite in such a way that they encourage weight regain (i.e. the body’s defence mechanisms which occur in the hypothalamus therefore are outside of our conscious control).
- With this in mind, we can conclude that obesity is not a lifestyle choice nor lack of moral fiber! It is a chronic progressive disease.
- People with obesity aren’t responsible for developing obesity, but they are responsible for what they do about it!
As I’ve said before, what people with overweight and obesity want to hear is
“I understand your health condition and I am here to help”.