Patient-centered approach to treating obesity

Date:
February 24, 2022
Source:
University at Buffalo
Summary:
In short, health professionals on both sides of the debate should
strive to improve access to compassionate, evidence-based and
patient-centered care in order to fight weight stigma and end diet
culture, the researchers argue, adding that the emphasis should
be on health, not weight.



FULL STORY ==========================================================================
It's one of the most polarizing questions among clinicians: Is treating
obesity while also reducing weight stigma and eating disorder risk
mutually exclusive?

==========================================================================
In a recent commentary published online ahead of print in the Journal
of the Academy of Nutrition and Dietetics, a team of researchers takes
aim at what they say is an outdated approach many health care providers
still have when it comes to treating patients with overweight or obesity.

In short, health professionals on both sides of the debate should strive
to improve access to compassionate, evidence-based and patient-centered
care in order to fight weight stigma and end diet culture, the researchers argue, adding that the emphasis should be on health, not weight.

"It is absolutely critical to unlink weight from diet culture," said
co-author Katherine N. Balantekin, PhD, RD, an assistant professor in
the Department of Exercise and Nutrition Sciences in the University at
Buffalo School of Public Health and Health Professions.

"In my opinion, this is the biggest disconnect we are currently seeing
in society," added Balantekin, who studies eating behavior in children
with obesity and disordered eating. "Working together to eliminate the
false dichotomy between eating and weight disorders will help ensure that everyone receives the compassionate care that they deserve. Moreover,
we need to continue to work on eliminating other barriers to treatment, including weight bias and stigma." Weight stigma -- the devaluation
of a person based on their weight -- is rampant, the researchers note,
citing previous research findings that more than half of health care
providers attribute a patient's being overweight or obese to a lack of willpower. This kind of fat-shaming only reinforces negative stereotypes,
they say.



==========================================================================
The debate extends far beyond health care settings. For example,
when Weight Watchers released Kurbo, a weight loss app for children
and adolescents in 2019, there was major backlash among eating disorder experts, dietitians and former dieters who criticized the app for placing
an emphasis on dieting. For many people, dieting has negatively impacted
the relationship they have with food and their body.

With Kurbo, "there was a lot of concern that any focus on weight would
cause eating disorders," Balantekin said. "People think of dieting as
being the same thing as obesity treatment, when in fact they are extremely different." The paper notes that a new definition of obesity, backed by Canadian guidelines and the World Health Organization, has emerged. Gone
is the emphasis on a body mass index (BMI) of 30 or above. Instead,
obesity is now defined as having excess fatty tissue that is associated
with negative impacts on quality of life or physical health.

"This new definition takes a health-focused rather than a weight-focused approach, allowing for improved sensitivity to the nuance of the
relationship between weight and health status," the researchers write.

It also allows for a shift toward supervised evidence-based obesity
treatment, which favors sustainable changes to promote long-term
health. This is instead of focusing on dieting or self-directed efforts to
lose weight by restricting the amount or types of food consumed. Whereas self-directed diets often promote unhealthy eating practices such as
fasting or strict food restriction, supervised evidence-based obesity
treatment actually improves health without increasing internalized weight stigma, the researchers write.



==========================================================================
The paper's key conclusion is that "treating obesity and reducing weight
stigma and eating disorder psychopathology are not mutually exclusive."
"There has been concern for a long time that weight loss can trigger
or worsen eating disorders, but a large body of research suggests that evidence-based obesity treatment actually improves, not worsens, eating disorder symptoms," Balantekin said. "This is true for both children
and adults." The researchers also call for broad policies such as laws
against weight-based discrimination, as well as efforts to further educate health care providers and the general public about the fact that numerous factors beyond self-control affect weight.

Obesity treatments should also screen for and address eating disorders throughout treatment so that individuals can receive specialized care
as soon as possible, Balantekin said.

"It is critical to take a patient-centered approach to treatment
with a focus on all health needs, which contrasts with the typical provider-centered approach with a focus on weight," Balantekin
added. "This means that health care providers need to respect a patient's wishes, including whether or not they want to discuss weight. It
also needs to include a conversation where providers clearly lay out
reasonable expectations for treatment, including how habits will need to
be sustained long-term to see maintenance of weight loss." The paper's
authors include researchers from the University of Florida, University
of Toledo, Brown University, Washington University in St. Louis, and
Florida State University, and Obthera, Inc.

========================================================================== Story Source: Materials provided by University_at_Buffalo. Original
written by David J. Hill.

Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. Michelle I. Cardel, Faith A. Newsome, Rebecca L. Pearl, Kathryn
M. Ross,
Jackson R. Dillard, Darci R. Miller, Jacqueline F. Hayes,
Denise Wilfley, Pamela K. Keel, Emily J. Dhurandhar, Katherine
N. Balantekin. Patient- Centered Care for Obesity: How Health Care
Providers Can Treat Obesity While Actively Addressing Weight Stigma
and Eating Disorder Risk. Journal of the Academy of Nutrition and
Dietetics, 2022; DOI: 10.1016/ j.jand.2022.01.004 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/02/220224120633.htm

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