You've heard it before: Obesity is in epidemic proportions in the United States, and it is linked to numerous health problems. It's a serious problem and needs an effective solution. And, the solution is out there, but it's not what people think.
Many people turn to their doctors for help. Unfortunately, according to Dr. Valerie Ulene - a preventive medicine specialist, many physicians are making the problem worse, not better. In an article in the Los Angeles Times last month (Doctors and nurses' weight biases harm overweight patients), she expressed her frustration with the prejudices that healthcare professionals hold and the unfortunate consequences of these attitudes. She referred to a study conducted by the University of Pennsylvania in 2003, which surveyed more than 600 primary care doctors on their views of obesity. The results showed that more than half thought that obese patients were "awkward, unattractive, and noncompliant." One-third viewed them as lazy and lacking willpower. Particularly concerning is that such prejudices were even held by physicians specializing in the treatment of obesity. Unfortunately, this study was not alone. Many other studies have also found that healthcare professionals, such as nurses, view obese patients negatively.
Dr. Uhle explained that prejudiced professionals often feel justified in their negative feelings and attitudes toward overweight patients. They lack compassion; and, instead, blame their patients for creating their weight problem through poor eating and not exercising. Some prefer not to care for these "self-sabotaging" patients; while others try to shame patients into losing weight. The result is that their patients feel shamed, demoralized, inadequate, and lose the motivation to try to lose weight.
Such humiliating interactions make overweight patients reluctant to follow up with any medical care. For instance, they are less likely to get cancer screenings. Of course, this means that they are likely to go untreated for a range of medical problems.
These observations of what often goes wrong in healthcare point the way to what professionals should be doing instead; providing support and encouragement. She even makes a call to action for physicians and nurses to provide a port in a storm of prejudice that overweight people face from family, friends, coworkers, and society at large. Hopefully, many patients have the psychological strength to take in that support and view themselves in a more positive light. Unfortunately, many will not feel sufficiently shielded and will instead feel ashamed; knocked down by judgments about them that, too frequently, they also believe.
So, for those patients who hold such prejudices about themselves, a caring doctor or nurse is not enough to help them lose weight. They must learn to understand the their problem compassionately - to approach themselves in a way that I call compassionate self-awareness. Both in relation to their weight issue and other struggles, they must learn to be aware of their inner experiences - such as frustration, sadness, or anger - without being overwhelmed by it. And, if they can do this while understanding that they are not alone; that their experience is a human one; then they can learn to respond more compassionately to their own pain. They will connect with the part of themselves that wants to lose weight and pursue its goal.
In keeping with this idea, two recent studies have revealed interesting findings. In a study published in the American Journal of Preventive Medicine , the authors found that motivational interviewing was effective in helping people shed pounds. It accomplishes this by acknowledging their ambivalence (I wish I could get into those smaller jeans without having to give up all the sweets.); but also highlighting the benefits they would like to get from losing weight (At a lower weight, I would feel great, lower my blood pressure, and finally get back into my old clothes.). In doing this, people connect with their inner motivation to meet their goal without being critical or having to deny any part of themselves. Another study, published in the Journal of Consumer Research, showed - in an entirely different way - how people were helped by connecting positively to the desire to lose weight and to themselves. The authors looked at Weight Watchers and found that this program is effective, in large part, because it offers support and grants forgiveness for failures to lose weight. Just like with compassionate self-awareness, motivational interviewing and Weight Watchers focus on helping people to feel positively about their desire to lose weight and their efforts to do so. These approaches help people to face the obstacles to weight loss more effectively and feel better about themselves as a whole person.
In the "battle" to lose weight, compassion makes a big difference. People need to approach themselves as a supportive friend, not the enemy; and they need to same support from those around them.
Dr. Leslie Becker-Phelps is a clinical psychologist in private practice and is on the medical staff at Somerset Medical Center in Somerville, NJ. She also writes a blog for WebMD (The Art of Relationships) and is the 'Relationship' expert on WebMD's Relationships and Coping community.
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