Bariatric Times - June 2008 - (Page 10)

10 Practice Management Perspective Bariatric Times • June 2008 The physician is often seen as the lynchpin of a multidisciplinary team, and is usually the first member, after the nurse, TO DISCUSS ISSUES OF WEIGHT AND LIFESTYLE WITH PATIENTS. adults reported that their healthcare professional did not advise them to lose weight. Too often during routine medical visits, the subjects of weight, nutrition, and physical activity are overlooked by the physician or brought up only as an afterthought, which can affect the level of perceived importance the patient assigns to these topics. Given the high personal and economic costs of obesity and its comorbid conditions, weight-related instructions and advice should be discussed early in the visit in simple, nontechnical language.7 Many physicians are unaware of how to approach the subject of weight. Asking permission to discuss weight and weight loss is a simple way to build rapport with patients and address this traditionally sensitive topic. Once the subject has been broached, the physician can use patient-centered communication to learn how patients feel and what they know. This opens the door to discussions on motivation and provides the physician with the opportunity to assess health literacy, an issue common to medical care. Such discussions take far less time than expected; if uninterrupted, patients usually speak about themselves for approximately two minutes.8 In general, a simple, three-minute lifestyle interview9 can give physicians a sense of whether patients’ nutritional patterns are reasonable, whether they are interested in losing weight, and what their emotional and physical obstacles might be. The physician is often seen as the lynchpin of a multidisciplinary team, and is usually the first member, after the nurse, to discuss issues of weight and lifestyle with patients. By using patient-focused communication strategies and emphasizing the importance of nutrition and obesity-related lifestyle factors, the physician can encourage patients to adhere to medical advice and view obesity as a significant but treatable health concern. THE REGISTERED DIETITIAN: LAYING THE FOUNDATION FOR DIETARY CHANGE In a multidisciplinary approach to obesity treatment, the primary role of the registered dietitian (RD) is to guide the patient toward simple, effective strategies to improve their diet quality and decrease overall energy intake. Confusion about food and diet is widespread, however, there are several simple strategies patients can use to reduce energy intake without inducing feelings of hunger than can lead to binge eating. Eating less. Over the past 30 years, the mean daily energy intake of Americans has increased from 2,450kcal to 2,618kcal for men and from 1,542kcal to 1,877kcal for women.10 Larger food portions are a primary contributor to higher energy intake, and consequently, the rise in obesity prevalence.11 Data indicate that the more food is served, the more people eat.12 When counseling and educating clients, food and nutrition professionals must consider that the portion sizes of foods sold in the http://www.ironintern.com http://www.ironintern.com

Table of Contents Feed for the Digital Edition of Bariatric Times - June 2008

Bariatric Times - June 2008 Endoluminal Treatment Options for Morbid Obesity: Devices and Techniques for Natural Orifice Approaches The Multidisciplinary Approach to Weight Loss: Defining the Roles of the Necessary Providers Acute Bleeding after Gastric Bypass Editorial Message Contents ASMBS: 25 Years Editorial Board Surgical Site Infection In The Morbidly Obese Patient: A Review Consultant's Corner The Link Between Sleep Loss and Obesity: Understanding the Mechanisms Responsible for Weight Gain with Sleep Deprivation Volume Matters Journal Watch Advertiser Index

Bariatric Times - June 2008

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