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

ArticleinScandinavian Journal of Public Health 39(1):98-105 · February 2011with16 Reads
DOI: 10.1177/1403494810391524 · Source: PubMed
Abstract
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.
    • "Overall, it appears that appearance is a greater motivator for younger people to lose weight [2, 3, 26] and it is not until the age of thirty five [2] or forty years old [3] that people want to lose weight for health reasons. Emotional reasons such as " mood " or " psychological reasons " were mentioned infrequently in the papers identified [22, 23]. It is debateable whether having health or appearance as a motivating factor for weight loss is more beneficial in terms of long term weight loss maintenance. "
    [Show abstract] [Hide abstract] ABSTRACT: Background Obesity is more prevalent in adults with intellectual disabilities (ID) compared to the general population. Motivations for weight loss may influence engagement with weight management programmes and have only been studied in adults without ID. Aims: To determine reasons given by adults with ID and obesity for seeking weight loss and whether these reasons differ from those of their carers. Methods Prior to a multi-component weight management intervention, participants were asked “why do you want to lose weight?” Carers were asked their views and these were compared to the answers given by the adult with ID. Responses were themed. The Fisher’s Exact analysis was used to test for any relationship between reasons for seeking weight loss and participants’ level of ID, age, gender and BMI. Results Eighteen men and 32 women; age 41.6 SD 14.6 years; BMI 40.8 SD 7.5 kg/m²; Level ID Mild (28 %), Moderate (42 %), Severe (22 %), Profound (8 %). Eleven were unable to respond. Six themes emerged; Health; Fitness / Activity / Mobility; Appearance / Clothes; Emotional / Happiness; For Others; Miscellaneous. The most frequent reason given overall and by women was “appearance.” Carers cited “health” most frequently and “appearance” least, rarely agreeing with participants. “Health” was given as a reason more from older adults and those with milder ID. No statistically significant associations were found between reasons for seeking weight loss and BMI age, gender or level of ID but the differing views of adults with ID and their carers were clear. Conclusions Views of adults with obesity and mild or moderate ID can be collected. The opposing views of adults and their carers may affect motivation for weight loss.
    Full-text · Article · Dec 2015
    • "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. "
    [Show abstract] [Hide abstract] 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.
    Full-text · Article · Dec 2013
    • "In the UK, for example, there have been a series of qualitative studies led by Ogden [24, 25] and by Brown2627282930 with data collected from interviews with patients and healthcare professionals. There have also been similar and community based studies in Australia313233, USA343536 and elsewhere37383940. A recent development has been in the synthesis of findings from across qualitative studies to draw out overarching themes about obesity experiences [41@BULLET@BULLET, 42, 43@BULLET@BULLET]. "
    [Show abstract] [Hide abstract] 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.
    Full-text · Article · Dec 2013
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