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March 22, 2012

Talking About Weight Control

I've recently attended a continuing education course and read a book regarding habit formation. In simplest terms, habits require a cue that encourages people to act a certain way that results in some sort of reward. Technically, habits are neither good nor bad, they simply are a loop system of cue, routine, reward.

However, when we begin applying habits to healthcare, we define habits as "bad" when they result in long-term harm. Drug abuse, whether illegal or prescribed, comes to mind. But in a health atmosphere where obesity is epidemic, eating habits must also be address by health care professionals. And this is where conversations with patients can get dicey.

Feelings around obesity, especially regarding children obesity, is fraught with uncomfortable emotions that can range from guilt to shame to outrage. Researcher have actually taken a survey to determine which terms are more or less desirable when having a conversation about weight. Obviously, terms that were more neutral and less stigmatizing, such as "weight," "unhealthy weight" and "high BMI" were deemed least offensive.

And here's where physical therapists and massage therapists may be able to play a role. Food is something everybody needs, so when encouraging people to change their eating habits, the idea of cutting back how much we eat becomes unproductive for long-term change. However, changing behavior patterns so that people become more physically active tends to change other habits, such as food choices. The idea is that once someone is doing one healthy thing for themselves, they make several changes toward healthy habits.

From experience, I find that assigning exercises as homework can have varying results. Too many exercises (more than 3 at a time) will likely not get done at all. Assigning a patient one exercise per office visit, to help decrease low back pain, for example, is more likely to result in compliance. And once a patient does an exercise that helps reduce their pain, chances are they will be willing to with the next exercise you assign them.

The trick to changing a habit to a healthy habit is to help the patient/client determine goals that align with their lifestyle. As professionals, we can play a supportive role as coaches or cheerleaders to motivate them toward those goals. Choosing the right way to frame the conversation can make the difference between success or never seeing them again.

Posted by linda at March 22, 2012 6:12 AM

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