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Thursday, 19 August 2010

Personality Filters For Weight Loss - So What! Or How?

James Lamper (of Weight Matters), our colleague and one of the NCFED therapists shows us a study suggesting the need for differing approaches based on personality filters for the vexed question of how to help people lose weight. We all know intuitively that there are many barriers to weight control; of which character, history, personal resources, skill-sets, support systems etc can help or hinder motivation and outcome success.

Kelly Brownell was one of the first obesity specialists who said that we have to find a way to target obesity programmes more helpfully because one size fits all approaches simply don’t work. The only system we have at the moment is based on a progression of increasingly invasive treatments based on  Body Mass Index. Cognitive Behaviour Therapy would, in this system, be the Gold Standard for the moderately overweight while surgery is the option for the super obese at risk of serious medical complications if nothing else had worked. (NICE Obesity Guidance 2006).

Then, in 2005 or so, the BBC Diet Trials programme conducted at the University of Surrey clearly showed that there are no outcome differences between different types of diet, although there were big individual differences between dieters in the long term. The  conclusion suggested that certain types of weight loss programme could be usefully targeted to character and lifestyle. A person who did not like meal plans would benefit from the low protein approach and the person who needed structure might succeed better the slimming club approach.

Research even points to gender differences with males clearly preferring a health approach with minimum rules and control while women prefer by and large to meet in groups and talk about their feelings.

The British Psychological Society is currently engaging the skills of a Working Party to investigate how psychologists can add to the debate. This working party to date examines the more complex barriers to change such as emotional eating which may, or may not, have its roots in early traumas or neglect. This all begs the question of choosing which treatment pathway to engage our client on and the assessment methods that such a selection process will involve.

The application of the term “metabolic” to personality typing is interesting and reminds us of diets which are based on biological metabolic typing which have sold quite a few books and which could be considered pseudo scientific (in the words of Susan Jebb - a weight loss expert).

The study below is only one model of behaviour change. Research into the management of diabetes points to another category. This refers to the individual whose best way of managing their illness ( putting other important life values in perspective) is to deliberately ignore it even at the risk to health and life. A good motivational practitioner must take all these features into account when helping a person to change. And there is another missing piece and that is the “metabolic typing”  of the therapist and how well he or she is able to adapt to the shifting status of their student.

So here is the study. Do you think it answers all the questions we need to ask about obesity. Or is it another piece of information that we need as therapists to place into our own untidy toolkit?

The Study (reproduced with acknowledgement to James Lamper)

A MicroMass study in the US reveals that while disease symptoms and treatment vary widely among individuals with metabolic conditions, there are remarkable similarities in patients' motivations to change behavior and the barriers that stand in their way. This 'metabolic mindset' offers a vital key to successfully motivating people to make difficult behavior changes.

Here are four types of metabolic patients, their percentage of the total study population, and suggested ways of motivating each:

Cruise Control (19%)

These patients follow their doctors' orders and manage their conditions pretty well, but may not understand the seriousness of their disease or the value of treating it by changes in behavior. This makes them vulnerable to backsliding. Strong and repeated reinforcement is a must, using self-assessment tools that concretely demonstrate the benefits of behavior change.

Taking Charge (30%)

These patients know the risks of unhealthy behavior and actively avoid them. They don't require intense investment or intervention by their physicians. Healthcare providers should engage these patients as advocates and invite them to share their expertise with other patients.

Disengaged (20%)

This group is highly susceptible to setbacks because they feel that improving their condition is beyond their control. Healthcare providers should applaud each small success with these patients and allow them to choose which behaviors to work on, one at a time. They should also plan for relapses.

Overwhelmed (31%)

These patients want to change but don't know how to start. It's important to raise their self-confidence by giving information in easy-to-digest bites, creating step-by-step action plans focused on small goals, and acknowledging their successes.

For obesity training with Deanne visit our website at www.eating-disorders.org.uk

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