If you are someone that deals with obesity or excess weight, and, especially, if you are a woman, you may experience discrimination socially and in the work world, which can cause a decrease in self-esteem and quality of life. The treatments are sometimes complex, chronic or can take a long time to see results. Social alarmism, media pressure, and flash diets that are so often mentioned in social media, make achieving satisfactory results more difficult.
Diverse studies have shown that the key to success in weight control depends on the degree of adherence to the diet (less so than the type of diet) and this depends, in turn, on the level of motivation of the patient.
This is what will determine both the way you understand your weight problem and the chosen treatment for your case. It is also important that the nutritional professional is able to motivate you to change your habits (eating and otherwise), especially those that might be extremely difficult to change.
Motivation is a great ally in weight loss therapy. A professional can gauge your level of motivation from the first visit with a few simple questions, which take into account both the answer and the conviction with which you respond.
In terms of expectations, the professional should put special emphasis on simple, clear, and realistic goals, in order to avoid frustration in case of relapse and reignite motivation and positivity when overcoming them. Goals related to weightloss, maintenance of that weight lost, and not regaining it.
One indispensable requirement of an effective treatment is the patient’s own motivations, something that can be detected with some basic questions and the conviction with which the patient responds.
Do you want to treat yourself?
Would you be willing to lose weight?
Do you feel able to face the treatment?
What is the main reason you want to lose weight?
What are you willing to do in order to achieve this goal?
Being conscious of the diversity of causes of obesity, the design of treatment should take into account the diverse variables: eating habits, eating and social behavior, anxiety level, image perception, etc.
The program should include a pre-treatment evaluation and a post-treatment evaluation, with the goal of identifying the resulting behavioral changes.
Once the level of motivation has been detected, the motivational interview is a useful tool to help increase the motivation of the patient, respecting their decisions, avoiding value judgements, and resolving behavioral ambiguities.
For example, if you attend the meeting with a high weight than before due to poor intake control, the correct mode of action is not judge you, but instead to empathize with you. The fact that you go to the meeting indicated that you are not indifferent to your behavior and you need help with treatment. In this case it is vital that the patient differentiates for themselves what is their real behavior and which behaviors should they adapt. This can be done with questions like “what do you think about what I’ve said?” or “would you like me to explain something else about what we’ve spoken about?” explains Dr. Aguilar, from the Gastroenterology Unit of HC Marbella.
Furthermore, it is indispensable to encourage positive reinforcement in the face of successes like moderate weight losses that considerably better self-esteem, social and sexual relationships, self-perception, and different attitudes toward food.
Us professionals should identify in which phase of change the patient finds themselves. This can help avoid rejections, incorrect interpretations, or a failure of the effectiveness of the treatment, notes Dr. Aguilar.
Psychologists Prochaska and Di Clemente elaborate on a model of change that arises with the goals of understanding how to produce the change in people in terms of a certain behavior.
In this way, they established 5 phases of change and in each of those the nutritional intervention, through either a more traditional form or another cutting-edge surgical technique, is performed at HC Marbella:
1. Pre-contemplation. You do not consider your behaviour worrisome since many times the possible health issues related to excess weight are not evident at first glance, such as in the case of the lipid profile. In this state, it is important to obtain more information, avoiding that which you have not requested in order to avoid resistance. For example: what can I do for you? or how can I help you? instead of: you should lose weight or your risk of cardiovascular disease will be elevated due to your obesity. It will be necessary that they help you to believe in your own capacity to change and the evaluation should be personalized.
2. Contemplation. You consider the problems and the possibility for change. The specialist should be able to help you develop the skills to change behaviour, offer you support, provide your materials to help you, and collaborate with you to make a suitable plan of action with concrete goals that are useful, attainable, and measureable in the short term. Goals may vary between a determined amount of weight lost, a decrease in blood pressure, or simply, not gaining more weight. The last goal may seem minimal, but it can also be attainable and realistic in the short term. Others can have a more gratifying effect, like a better quality of life (being able to tie one’s shoes, breath, sleep better…).
3. Action. In this phase, it is important to increase the feeling of self-sufficiency, offer support and help you to prepare yourself to face possible problems.
4. Maintenance. You will often see the longing for pleasure that caused the attitudes that you are now abandoning: take certain foods that you liked, a nap on the couch instead of exercising… In these cases, the specialist should help you prepare for possible relapses. If possible, assess high risk situations and together develop coping skills. Ex: How do you see the continuing your diet during the holidays? What types of exercise seem the most appropriate when it’s cold outside?
5. Relapse. The main task the specialist will help you to understand are the causes of relapses and how to make plans for the next attempt, offering you support and promoting your self-confidence. And if you relapse, it is necessary to help you understand that this fact does not mean failure and it is a normal part of the process of change and, even, necessary in the learning process to understand the roots of certain habits.
If you, or any of your children, are overweight, don’t hesitate to consult us.
At HC Marbella, we help you so that obesity does not negatively affect your quality of life, nor that of the people around you, in a stress-free environment, that is comfortable and modern that helps the patients feel as comfortable as possible, with your integral team of nutritionists, psychologists, and nurses that will accompany you through the entire process.
March 4, 2021
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