Group treatment of obesity in primary care practice: A qualitative study of patients' perspectives

Karlstad University, Karlstad, Sweden.
Scandinavian Journal of Public Health (Impact Factor: 1.83). 02/2011; 39(1):98-105. DOI: 10.1177/1403494810391524
Source: PubMed


To explore patients' experiences of very low calorie diet (VLCD) and subsequent corset treatment of obesity in a primary care setting, and to explore their perceptions of factors influencing weight control.
In western Sweden, five focus group sessions were carried out. The main themes for the discussions were the informants' perceptions of the treatment they had received and their experiences of living with obesity. The analysis was based on the Grounded Theory methodology.
The outcomes reflect obese individuals' struggle to handle the demands of their life situation and to recognize their own resources. The core category generated was labelled ''Achieving a balance in life and adjusting one's identity''. Three categories related to the process of weight reduction were identified: living with obesity, reducing weight and developing self-management. The group treatment with VLCD was positively perceived by the participants, but the corset treatment was considered to be of less value.
Maintenance after weight reduction was demanding and the findings indicate a need for extended support. For some individuals the corset treatment could be a psychological support. Follow-up after weight reduction programmes should focus on long-term self-help strategies.

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    • "All patients wanting to lose weight in the next six months reported health as the top reason. This is consistent with other studies where [29] health reasons were the main motivating factors for attempting weight loss among overweight or obese people [10,12]. Although weight loss in those already in the healthy weight range does not provide increased health benefits, those in the normal weight group similarly indicated that their top reason for intending to lose weight was for health. "
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    ABSTRACT: The high prevalence of overweight and obesity in the population is concerning, as these conditions increase an individual's risk of various chronic diseases. General practice is an ideal setting to target the reduction of overweight or obesity. Examining general practice patients' intentions to lose weight and preferences for assistance with managing their weight is likely to be useful in informing weight management care provided in this setting. Thus, this study aimed to: 1) identify the proportion and characteristics of patients intending to change weight in the next six months; 2) reasons for intending to change weight and preferences for different modes of weight management assistance in overweight and obese patients. A cross-sectional study was conducted with 1,306 Australian adult general practice patients. Consenting patients reported via a touchscreen computer questionnaire their demographic characteristics, intention to lose weight in the next six months, reasons for wanting to lose weight, preferred personnel to assist with weight loss and willingness to accept support delivered via telephone, mobile and internet. Fifty six percent (n = 731) of patients intended to lose weight in the next six months. Females, younger patients, those with a level of education of trade certificate and above or those with high cholesterol had significantly higher odds of intending to lose weight. "Health" was the top reason for wanting to lose weight in normal weight (38%), overweight (57%) and obese (72%) patients. More than half of overweight (61%) or obese (74%) patients reported that they would like help to lose weight from one of the listed personnel, with the dietitian and general practitioner (GP) being the most frequently endorsed person to help patients with losing weight. Almost 90% of overweight or obese participants indicated being willing to accept support with managing their weight delivered via the telephone. Most overweight or obese general practice patients intended to lose their weight in the next six months for health reasons. Younger females, with higher level of education or had high cholesterol had significantly higher odds of reporting intending to lose weight in the next six months. An opportunity exists for GPs to engage patients in weight loss discussions in the context of improving health. Interventions involving GP and dietitians with weight management support delivered via telephone, should be explored in future studies in this setting.
    BMC Family Practice 12/2013; 14(1):187. DOI:10.1186/1471-2296-14-187 · 1.67 Impact Factor
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    • "This was supported by the finding that the interaction between dental anxiety and dental visiting habits was significant, in accordance with one other study [5]. The self-perceived general health, i e an aspect of quality of life, was also lower in this group which is concordant with other studies in obese people [28,29]. "
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    ABSTRACT: Background In western Sweden, the aim was to study the associations between oral health variables and total and central adiposity, respectively, and to investigate the influence of socio-economic factors (SES), lifestyle, dental anxiety and co-morbidity. Methods The subjects constituted a randomised sample from the 1992 data collection in the Prospective Population Study of Women in Gothenburg, Sweden (n = 999, 38- > =78 yrs). The study comprised a clinical and radiographic examination, together with a self-administered questionnaire. Obesity was defined as body mass index (BMI) > =30 kg/m2, waist-hip ratio (WHR) > =0.80, and waist circumference >0.88 m. Associations were estimated using logistic regression including adjustments for possible confounders. Results The mean BMI value was 25.96 kg/m2, the mean WHR 0.83, and the mean waist circumference 0.83 m. The number of teeth, the number of restored teeth, xerostomia, dental visiting habits and self-perceived health were associated with both total and central adiposity, independent of age and SES. For instance, there were statistically significant associations between a small number of teeth (<20) and obesity: BMI (OR 1.95; 95% CI 1.40-2.73), WHR (1.67; 1.28-2.19) and waist circumference (1.94; 1.47-2.55), respectively. The number of carious lesions and masticatory function showed no associations with obesity. The obesity measure was of significance, particularly with regard to behaviour, such as irregular dental visits, with a greater risk associated with BMI (1.83; 1.23-2.71) and waist circumference (1.96; 1.39-2.75), but not with WHR (1.29; 0.90-1.85). Conclusions Associations were found between oral health and obesity. The choice of obesity measure in oral health studies should be carefully considered.
    BMC Oral Health 11/2012; 12(1):50. DOI:10.1186/1472-6831-12-50 · 1.13 Impact Factor
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    ABSTRACT: Health professionals have a role in supporting pa-tients with weight management. Good training is available but has yet to be widely implemented. The required content of training is clear except perhaps how to address negative attitudes that stem from obesity stigma. There is good evi-dence that healthcare professionals hold and perpetuate the negative stereotypes and attributions that are core elements within obesity stigma and weight bias; with consequences for relationships with patients and their experiences of care. There may also be consequences for health outcomes but more research is needed. Further studies should triangulate weight bias attitudes with robust observation of healthcare processes and outcomes. This will help determine whether training about weight bias can simply reside in the general preparation of healthcare professionals (as part of anti-discriminatory practice for example) or, whether it requires more active interventions to change practice.
    12/2013; 2(4). DOI:10.1007/s13679-013-0070-y
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