A Zoom Visit to Your Scale: Dieting During COVID-19
Weight gain during quarantine was a foregone conclusion...
Posted Jun 01, 2020
As clothes not worn for weeks are replaced by sweat pants, difficulty in moving a zipper or button to close the waistband may reveal the consequences, in pounds, of sheltering at home. Continuous proximity to the kitchen, the inability to engage in the physical activities associated with previous unfettered routines, in addition to the unrelenting stress of isolation and worry, have caused many of us to gain weight. Even if we avoid getting on the scale, we cannot rationalize the difficulty in fitting into our pre-COVID-19 wardrobe as shrinkage from the dryer.
Were these normal times, we might deal with our weight gain by signing up for a weight-loss program that required weekly meetings and weigh-ins, or by meeting with a nutritionist over a period of weeks, or just ignoring the extra pounds until forced to be weighed during the annual medical check-up. But right now, no one else is going to weigh us. Indeed, monitoring many aspects of our health care in a face-to-face setting is no longer possible. Most non-critical medical care is being delivered by something called telehealth using FaceTime on a cell phone or videoconferences through programs such as Zoom.
When the medical community realized that having patients come to them during the COVID-19 crisis would put both them and the patient at risk, they turned to a medical diagnosis and delivery system that has been in place for years but used in a fairly limited way. Concern over whether this alternate method of providing health care would be acceptable to patients was even studied. The results were published in January 2019, before telehealth indicated that it could be an alternate route of health care delivery.
And then the pandemic suddenly made office visits off-limits. Many hospitals responded by using telehealth (or telemedicine systems) as a replacement. As described in an article in Yale Medicine, typically, telemedicine or video visits are carried out using smartphone apps, Zoom, and other types of video conferencing. The patient’s privacy is ensured in keeping with HIPAA, the federal law that protects patient confidentiality. Physicians claim that they can be more efficient using telemedicine, and patients have the benefit of not enduring long waits in an office waiting room.
Telemental health is also being used to offer virtual therapy for patients with mental disorders, given that the impact of the pandemic on increasing universal stress has made this type of therapy critical. According to this review, it has been possible to carry out evaluations, prescribe medications, and deliver therapy using video conferencing such as Zoom. This is especially important due to the increased level of stress and anxiety being experienced by patients who are already depressed or suffer from anxiety disorders.
Remote weight-loss support providing food plans, counseling, and exercise support has been around for several years. But much of the counseling is done by phone, i.e., the use of apps that track exercise and calorie consumption, and web-based support programs. But now it is possible to expand easily into frequent video conference calls between the weight-loss counselor and the client. And since the counseling is taking place in the patient’s home, the technology of Zoom or FaceTime might make the support more effective than one occurring in an office or support group.
For example, Zoom or FaceTime on a cell phone camera could be used to check and record the patient’s weight. Many of us hate to weigh ourselves if we think we have gained weight but will do so if asked by our physician or leader of a diet support group. The dieter could show the contents of the pantry and refrigerator and ask for help in cooking methods. It might even be possible to share a YouTube or other video option to demonstrate a healthier method of food preparation.
Some dieters don’t eat enough, especially during the early stages of a diet, and many eat too much because food is never measured. A video conference could be used by the dieter to demonstrate the actual portion sizes he is planning to eat. By making the dieter weigh and measure the food in front of the weight-loss counselor, the importance of making these measurements is emphasized. Something as simple as walking around the home with a cell phone on FaceTime may reveal where the temptation to overeat lurks: an open box of cookies left by a teen, a bowl of nuts not put away, soda bottles in the pantry, and even leftover pizza in the fridge are signs of possible diet obstacles.
Video conferences or Zoom sessions give other members of the family an opportunity to offer support and reveal, perhaps unwittingly, family sources of stress over food and other issues. Giving a food plan to the dieter in an office or support group setting, however, does not easily translate into altering the food patterns of the rest of the family. How the dieter can handle his food restrictions while allowing the rest of the family to eat as before is something a weight-loss counselor can discuss with everyone on a video conference. And if allowed to do so, the weight-loss counselor can talk to the family about how important it is for the dieter to have time to exercise along with some private time, how they as a family can relieve her of some of the household obligations she now fulfills herself, and the best way to support her over the months it might take for her to reach her weight-loss goal.
Plus, the client will have no excuses for not showing up at the office for an appointment.
“Patient and Clinician Experiences With Telehealth for Patient Follow-up Care,” Donelan K, Esteban E, Barreto A, et al, Am J Manag Care. 2019; 25:40-44.
“Want to See a Doctor Amid Covid-19? Use Telehealth,” Macmillan C, Raven K, Katella K, and Moriarty C, Yale Medicine March 31, 2020.
“Telemental Health in the Context of a Pandemic: the COVID-19 Experience,” Whaibeh E, Mahmoud H, Naal H, Curr Treat Options Psychiatry. 2020; 1‐5.