Seeking help for Obesity

Obesity is a life-threatening condition if left untreated (click here for medical complications).  Most people wish first to deal with the visible aspects of the problem, i.e. the excessive weight.   Treatment for weight loss often focuses around the areas of exercise and diets and seldom includes a psychological component.  Those programmes that do offer some psychological input, usually offer practical advice on how to deal with stress or how to gain control over food, such as putting less food on a plate, or not shopping on an empty stomach.  This kind of help offers only minimal relief and I think often leaves individuals feeling more helpless and further entrenched in their problem.

Obesity is a multi-factorial problem that requires an inter-disciplinary approach.  That is, a team of professionals should deal with the problem.  The following professionals should be consulted.

1.

The family physician will exclude the possibility of any medical factors that may be causing the problem.  Remember that only 3% of obesity is due to a physical condition (see identification).  Please ask him/her for the name of a reputable psychologist who works with eating disorders. 

 

2.

A psychologist.  If you know of a reputable psychologist who works in this area then s/he can be approached directly.  This is not a problem that can be solved in a few sessions and long-term therapy is usually required. See causes to understand the kind of psychological factors that are at play with obesity. Do not dabble with this problem.  Seek the right help as soon as possible. Usually psychologists who work with eating disorders work in conjunction with a dietician.  (Click here to find out what you can expect from the psychological assessment).

 

3.

A dietician.  As commented above, eating disorders can never be treated from the dietary aspect alone (see causes).  Dieticians who specialize in eating disorders will work in conjunction with a psychologist.

 

4.

A psychiatrist, if necessary.  Usually the family physician and the psychologist can assess whether this problem requires the additional input of a psychiatrist.

 

5.

An exercise specialist.  You may wish to consider a weight loss programme that offers exercise as a component, or a personal trainer.  Seek help from the right people. SARPT - S.A. Registered Physical Trainers.

An attempt to change only the symptom is one of the reasons why people with an eating disorder constantly appear at different programmes.   Few people have only been to one programme.  It is important to catch the manifestation of the problem as early as possible, as there is a strong likelihood that the individual will simply move onto the next programme if the clues are ignored.   Please bear in mind that there are psychological and historical causes of obesity.  It is never just about too much food or the lack of exercise!

 

TREATMENT FOR THE OBESE (OR OVERFAT) PERSON

1.

Exercise

2.

Healthy eating plan (see why diets don't work).

3.

Medication   

4.

Therapy

5.

Surgery

6.

Behavioural methods:

1.

Food diaries

2.

Awareness of cues or trigger factors that set off the eating pattern

3.

Teach new eating patterns

If you want to lose weight, or want to help someone lose weight, de-emphasise weight loss!  Create structure, e.g. three meals a day and strike the word diet from your vocabulary. Learn to listen to your body signals.

The input-output theory obviously holds here in that a lack of exercise and excessive food intake results in excess weight.  A pattern of excessive eating has probably continued for a number of years, but the point at which a person decides to change this behaviour, s/he may not be eating very much at all. Overweight individuals have moved from one weight loss programme or diet to another, and usually end up getting larger and larger.  The importance of prevention is therefore imperative.  If you are weighing approximately 20kgs over your recommended weight, then try and find someone who will help in a holisitc fashion.  Do not try and address your eating, exercise or psychological aspects in isolation.  If you attempt to change only one aspect, you may be disappointed and will end up moving from one programme to another.

I am not being negative, simply a realist.  I believe there is a point at which it becomes incredibly difficult to change obesity.  There are numerous new medicines out, such as fat inhibitors, fat burners, etc, but these do not always work.  I think that once you have been obese for a certain amount of time you identify with that obese personality and it becomes very difficult to change the picture.  Prevention is better than cure!

The following are tell-tale signs to watch for if you are struggling to lose weight on a particular programme or regime:

1.

You are not losing weight.

2.

You have gained weight.

3.

There are weight fluctuations.

4.

You are losing motivation.

5.

You start to miss training sessions, feel like "cheating" on your diet, etc.

6.

You are feeling depressed or lethargic.

Remember:

1.

Obesity that has commenced in childhood (i.e. juvenile onset obesity) is more difficult to change than adult onset obesity.

2.

The more diets that you have been on, the harder it will be for you to change your behaviour.  Stop dieting and get the right help now! (See why diets do not work).

3.

The longer you have had this problem, the more difficult it will be to change it.