Thank you Perryn x.
Don’t be patronising. Weight loss is hard and it takes a lot of physical and emotional effort. In a society that is booming in the waist and media coverage around weight loss, a perception has developed that it is down to personal control (that is, one who is overweight/ obese has no control or is ‘lazy’). A large review published in Obesity (a research journal) in 2012 highlighted the extent of weight stigmatisation, which appears in the work place, media and sadly, in health care.
Recent statistics have reported that 1 in 4 of us is classed as obese in the UK. Putting this into context, 1 in 4 of your family or friends may be stereotyped by others as being lazy, lacking discipline, sloppy and unattractive.
Why do some people have better control over their weight whilst others struggle?
If you have a good eye for mazes and puzzles have a look at the ‘Shift Obesity Influence Diagram’ below, which highlights the complexity of barriers to weight loss which include:
- Biological (genes)
- Social influence
- Medical health and associated treatments (e.g. medications which may stimulate appetite)
- Emotional health
- Environment (associated to physical activity and food availability) and
- Food consumption.
Needless to say, it’s a bit patronising to say ‘eat less, move more’. As an obesity Dietitian, the above influences are always in the back of mind when I first meet a client. Why? Unless the people I see have lived under a rock for the last 50 years, they know the key nutritional messages to benefit their weight, and have been trying to implement them.
Weight loss client journey considerations
- ‘Don’t judge a book by its cover’. This best sums up supporting anyone with weight loss. In my career, I have yet to witness a stereotypical weight loss client. Come to think of it, if there was a common weight loser, would there be an obesity epidemic?
- Exercise does not always create weight loss. If you’re doing high volumes of exercise and weight is not shifting, then energy intake may be compromising efforts.
- No food is a silver bullet. Unfortunately research has yet to uncover a food that creates lengthy increases in basal metabolic rates (fat burning). For weight management, consider food portion sizes.
- The answers are not obvious. In regards to diet, people always look for the obvious and provide advice around this. e.g. reduce fats and sugars. If it were obvious, clients would not be seeing a professional, as a simple Google search would have answered all their questions.
What are the diet considerations for overweight/ obese:
Everyone is different and everyone has his or her barriers to weight loss. From a diet perspective, I might support clients with:
- Re-education of diet advice for weight loss and discuss the research
- Learning what is hunger (when to eat)
- Learning what is fullness (when to stop eating)
- Learning what is not hunger (triggered eating as response to environment, emotion, thoughts)
- Tailoring diet advice into their busy lifestyle (e.g. If they are time limited at breakfast time, they’re not going to sit down for cereal and milk. They need something convenient and enjoyable so they don’t skip).
- Cooking ability (if they don’t know how to cook their favourite meal, it makes sense they will go out and be at the mercy of chefs and takeaway cooks rich meals)
- Shopping (how to read a label, what is high fat or sugar, what is too big or too small)
The above are a drop in the ocean in what I do in sessions and direction of support differs amongst client. In other words, everyone is different, and everyone has his or her challenges. Weight loss is hard and if you have a good understanding of your client’s personal barriers and struggles you will both make a great team for weight loss.
What do you think is the hardest barrier to weight loss? What do you think more people need support with when they are planning to lose weight?
Perryn Carroll is a weight-loss dietitian who actively contributes and comments on obesity management issues. A self-confessed diet geek, Perryn writes for her website, Diet Duchess. She also regularly guest blogs and is a media spokesperson for the British Dietetic Association. If she’s not tackling weight-loss issues, she’s tracking down the world’s best coffee.