Weight Management – A Collaborative Approach

Once the patient has agreed to enter into a discussion about weight management, the aim is to discuss in a collaborative manner the health benefits of lifestyle change and weight loss as well as different management options. However, before advising patients, it is essential to first establish their level of understanding regarding weight management and the type of information they would like to discuss and explore.

Weight Management Education

As an example, losing 5-10% of body weight can be effective in reducing symptoms and improving function in people with knee osteoarthritis. The importance of communicating this evidence accurately and sensitively has been highlighted (“For some people with knee osteoarthritis, losing 5-10% of body weight can help reduce their pain and improve symptoms”) with weight loss presented in a menu of conservative treatment options which the patient can choose to engage with or not. If a patient experiences multiple comorbidities you can extrapolate the benefits of weight loss to these other conditions. For example, “as well as being potentially beneficial for your knee pain, weight loss of 5% or more is associated with improved prevention, delayed progression or improved control of type 2 diabetes as well as improvements in kidney disease, sleep apnoea, gastro-oesophageal reflex, urinary incontinence and mental health.”

Weight Management – Topics to Discuss

• Diet, exercise and broader interventions addressing sleep, mood and thoughts and habits around food all can be effective for weight loss – and are more effective when combined.
• Weight loss is difficult, but there are many things that improve the chances of someone losing weight and maintaining weight such as having a support person, working with a health professional as well as goal setting and self monitoring progress towards that goal.³
• Physical activity and exercise, as an adjunct to any weight loss intervention, have benefits for energy expenditure, mood, confidence, healthy lifestyle habits, body image as well as maintaining lean muscle mass, which otherwise would be lost in proportion to loss of fat mass.
• Individual studies have found benefits from a range of different diets including low-fat, low-carbohydrate, vegetarian, Mediterranean, Dash, CSIRO diets but the collective literature indicates that no single diet is best for weight loss (these will be discussed in detail in week 5). Therefore, patients should be advised to select diets or to make gradual dietary modifications based on their specific needs and personal preferences to maximise confidence and long-term adherence.
• Multi-disciplinary approaches are likely to be beneficial for complex patients. These options should be discussed including exploring patients’ attitudes and experiences and understanding of other disciplines and approaches, including group programs in the community.