Uncovering What Makes Patients Take the First Step in Getting Help with Weight Loss

Whether as a New Year’s resolution or in response to a health scare, at some point most of us have resolved to do better when it comes to taking care of our health. We decide we are going to eat right, exercise, meditate daily…starting tomorrow. Or maybe the day after that.

Changing health behaviors is hard. What is it that makes some of us take the plunge into lifestyle change, while the rest of us watch from the shoreline? And can our doctors help motivate us to take steps towards making these changes?

offering different programs with different features, or personalizing our programs, may help us meet the needs and wants of more people. This could help more of them take that first step of starting a weight loss program.

We addressed these questions in a study published in the March 2017 issue of Translational Behavioral Medicine. We compared people who started a weight loss program to people who never took the first step of joining. This study was conducted in the Veteran’s Affairs Health Care system, where a free behavioral weight loss program is available for eligible patients, and all of our study participants were offered entry into this program during a medical visit.

We found a few key characteristics that differed between those who initiated the weight loss program and those who did not. Those who started the program were more likely to be single, and reported more anxiety. Interestingly, those who joined the weight loss program and those who did not reported different experiences with the medical visit in which they were offered the weight loss program.

The participants who went on to join the program reported they felt their health care provider was more understanding of their perspectives about weight and weight loss, and more supportive of them making their own decisions about how they want to address weight. In other words, a doctor who told patients “You should go to this weight loss program” was probably less successful in motivating a patient than a doctor who asked “How do you think this weight loss program might work for you?”

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For many doctors, this kind of gentle, patient-centered approach comes naturally. For others, it can be a challenge to let the patient take the lead. Fortunately, there are strategies that can help health care providers become more skilled at respecting patients’ autonomy and helping them make their own choices about how they want to address their health. One of the best established approaches to facilitate this kind of communication is motivational interviewing.

We asked ourselves why single and more anxious individuals were more likely to join a weight loss program. Our thought is that those who are single may be more driven to lose weight because they feel it will help their romantic prospects. Or maybe they just have more time on their hands than married individuals, who might also be more likely to have children. Those who reported higher anxiety might have been more worried about how their weight was affecting their health, and thus more motivated to join a program. Future studies should more carefully measure these different factors to test these hypotheses.

there are strategies that can help health care providers become more skilled at respecting patients’ autonomy and helping them make their own choices about how they want to address their health. One of the best established approaches to facilitate this kind of communication is motivational interviewing.

We also asked our study participants to tell us what features they preferred in a weight loss program. After all, it may not be enough to offer a weight loss program that we think will work. It may be that we need to offer people the programs they really want in order to get them motivated to get started.

Among our study participants, most people (69%) reported wanting in-person sessions (not telephone or web-based) and most wanted treatment to have a mood management component (70%). When it came to other features of the program, however, opinions were more divided. Some wanted a group format (42%) while some preferred one-to-one contact (58%); some preferred a program with a focus on small, gradual changes (59%) and some wanted a focus on large, immediate changes (41%).

What this tells us is that offering different programs with different features, or personalizing our programs, may help us meet the needs and wants of more people. This could help more of them take that first step of starting a weight loss program.

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