Weight Management and Getting Your Clients to Be Compliant!
There are tons of articles on how to help your clients with weight management, as well as many different herbs and products, various exercises, and habits to help support the body’s metabolism. But how many of you struggle with compliance above and beyond anything else? If your clients could implement even one or two of your recommendations, how big of an impact would that make?
You are not alone. This is a problem that health practitioners of all backgrounds face. No one doubts that weight management is a huge problem in today’s society and that obesity is an epidemic. But very few providers have successfully implemented weight management protocols that actually stick!
Providers are sharing their thoughts and researching various approaches on how to do just that. In Ayurveda, we know that the answer lies in supporting the digestive fire (agni) and decreasing kapha through diet and lifestyle. Consider these additional ideas on how to make those efforts both sustainable and successful:
- Ayurveda appreciates that each tissue in our body holds energy. Fat, specifically, has the emotional and energetic qualities of kapha—love and comfort. Furthermore this extra tissue is “extra baggage,” in a physical sense and an emotional sense. Research shows that depression is more prevalent in obese patients and that weight gain can increase dramatically during episodes of depression.1 Often we see our clients with weight challenges holding on to something (pain, an incident, a lost companion, grudges) or trying to provide themselves with a sense of love and comfort that they cannot seem to give themselves. Explore these topics with your client. Help them shed the weight they have been carrying!
- Try motivational interviewing.2 The key is to express empathy and support self-efficacy. This approach focuses on reinforcing positive behaviors and compliance to a plan with a series of short-term successes. The inertia of kapha needs that constant boost from feeling successful to keep going. Ask your clients what a good, realistic first step would be (is it cutting just one soda a day, cutting back from five fried meals to three fried meals a week, cutting just 100 calories a day, taking one herbal supplement a day?). Help your client feel like she or he is in control.
- Start with just 5–10% of the body weight. Clients get overwhelmed when they hear goals like their ideal body weight should be half of their current body weight. But research shows that cutting the body weight by just 5–10% can have quite dramatic results on health (regulation of menstrual cycles, improvement in blood pressure and cholesterol, for instance). Start with this very realistic goal.
- Make sure that you are very specific in your plan or recommendations and write it out! Advising a client to just do yoga or get exercise three times a week is rarely sufficient.3 You want to specify duration, type of exercise (even type of yoga), number of calories, number of beverages, and so forth.
- Make sure your clients understand fully the benefits (short term and long term) of having a healthy weight. Healthy weight is more than vanity and heart disease or diabetes. Explore in detail how weight impacts all aspects of health (i.e. cancer rates, sleep, brain health, reproductive health including fertility).
- Have your client then share what barriers may keep him or her from being successful with the plan that you have determined together. Is it cost, time, or simply remembering to do something? Then find solutions with your client. There are many apps available now to remind clients to take a tablet, to work out, and to count calories. Help your clients manage their schedule to create time for the chosen plan, or shorten the plan if necessary. Also try a pillbox to help with remembering to take the herbs.4
- Follow-up with your client within a month. Recognize that the initial weight loss at one month is believed to be the biggest predictor of weight loss after twelve months.
- Kapha needs constant support and motivation. You can also create support groups (pair up clients with the same challenges to be accountability buddies), have your assistant follow-up with them, or do “weigh-in’s” via email or Skype.
- Above all, make sure that you are being patient, compassionate, and understanding. These clients need someone who believes in them and their ability to be successful. You can be that one person who changes everything for your client! Do not underestimate your potential to be impactful.
1 Laura Pratt and Debra Brody, Depression and Obesity in the U.S. Adult Household Population, 2005-2010. NCHS Data Brief: Centers for Disease Control and Prevention, Accessed November 20, 2015, http://www.cdc.gov/nchs/data/databriefs/db167.htm.
2 Mary Beth Nierengarten. Motivational Interviewing in Primary Care Reduces Obesity. Medscape, Accessed November 20, 2015, http://www.medscape.com/viewarticle/842242
3 Beth Skwarecki, Weight Loss: Primary Care Behavioral Counseling Can Help. Medscape. Accessed November 25, 2015.
4 Imran Aslam, Steven Feldman. Practical Strategies to Improve Patient Adherence to Treatment Regimens. South med J. 108, no. 6 (2015):325-331.