Has the individual sought weight loss on his or her own initiative?
Weight loss efforts are unlikely to be successful if patients feel that they have been forced into treatment by family members, their employer,or their physician. Before initiating treatment, health care practitioners should determine whether patients recognize the need and benefits of weight reduction and want to lose weight
What events have led the patient to seek weight loss now?
Responses to this question will provide information about the patient’s weight loss motivation and goals. In most cases, individuals have been obese for many years. Something has happened to make them seek weight loss. The motivator differs from person to person.
What are the patient’s stress level and mood?
There may not be a perfect time to lose weight, but some are better than others. Individuals who report higher than usual stress levels with work, family life, or financial problems may not be able to focus on weight control. In such cases, treatment may be delayed until the stressor passes, thus increasing the chances of success. Briefly assess the patient’s mood to rule out major depression or other complications. Reports of poor sleep, a low mood, or lack of pleasure in daily activities can be followed up to determine whether intervention is needed: it is usually best to treat the mood disorder before undertaking weight reduction. .
Does the individual have an eating disorder, in addition to obesity?
Approximately 20 percent to 30 percent of obese individuals who seek weight reduction suffer from binge eating. This involves eating an unusually large amount of food and experiencing loss of control while overeating. Binge eaters are distressed by their overeating, which differentiates them from persons who report that they just enjoy eating and eat too much.”Ask patients which meals they typically eat and the times of consumption. Binge eaters usually do not have a regular meal plan; instead, they snack throughout the day. .
Does the individual understand the requirements of treatment and believe that he or she can fulfill them?
Practitioner and patient together should select a course of treatment and identify the changes in eating and activity habits that the patient wishes to make. It is important to select activities that patients believe they can perform successfully. Patients should feel that they have the time, desire, and skills to adhere to a program that you have planned together. .
How much weight does the patient expect to lose?
What other benefits does he or she anticipate?” Obese individuals typically want to lose 2 to 3 times the 8 to 15 percent often observed and are disappointed when they do not. Practitioners must help patients understand that modest weight losses frequently improve health complications of obesity. Progress should then be evaluated by achievement of these goals, which may include sleeping better, having more energy, reducing pain, and pursuing new hobbies or rediscovering old ones, particularly when weight loss slows and eventually stops.
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