Debunking Diet Myths With Patients

In this exclusive video, Robert Kushner, MD, a weight management specialist at Northwestern University Feinberg School of Medicine in Chicago, discusses common misconceptions that patients may have about weight loss and gives suggestions about how to advise patients about long-term solutions to this chronic and medically based condition.

The following is a transcript of his remarks:

The most common misperception I get from patients is they think that their weight is entirely their fault — that they bring it on themselves; that they know what to do, but if they only had more willpower, they could control their body weight — it’s like if they study for an exam and stay up all night, they can pass the exam because it’s under their control.

The thought about obesity has changed dramatically over the past two to three decades. We now consider obesity to be a chronic, relapsing, progressive disease, like type 2 diabetes, of which personal behaviors clearly have a role — i.e., what I eat, do I move my body around, do I get a good night’s sleep? But that ignores the other important determinants that will affect your weight like genetics, biology, your environment, access and affordability, and other medications you’re taking, which would be called echogenic weight gain.

So really, that is the most important issue: people think that it’s their fault and there’s nothing else that could be done other than needing motivation, and that’s not how we think about obesity anymore.

When I see patients who are either overweight or have obesity, either seeking care directly or I bring it up proactively by broaching the topic, after telling them it is an ongoing medical problem or disease, I usually start the conversation by talking about the continuum of care. What are the resources that are available to help them manage their weight? I do that so they understand there are always other treatments, and if they don’t do well with one, then there are other more aggressive treatments we could rely on.

So, I break all the treatments up into three different buckets. The first is lifestyle:…

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