...... Once in independent practice, health care professionals implement the principles that were learned throughout their educational experience. Consider the following:

• Professional approaches to weight loss based upon the old paradigm usually consist of individual sessions of weight checks and physician encouragement coupled with:
• Referral to a dietitian for nutritional education.
• Consideration of referral to a counselor/ behavioral therapist for assistance in achieving weight loss.¹
• In addition, providers sometimes recommend specific weight loss methods that may be ineffective and even unsafe.
• Problems with the traditional approaches:
• If weight loss is defined as a desired "behavior", then behavioral management may be inappropriate. Because weight loss is an outcome (not a behavior),² attempting to reinforce it may inadvertently strengthen unhealthy behaviors like vomiting, fasting, or drug abuse.
• Traditional approaches have been shown to be disagreeable to many patients and largely ineffective as well.³
• The ethical foundation and professional compatibility of old paradigm weight loss interventions has been questioned:⁴

 
• "It is now widely agreed that obesity treatment is, in general, ineffective. It may be argued moreover, that it is more than ineffective: in many instances it is destructive. It may provide patients with failure experiences, expose them to professionals who hold them in low regard, cause them to see themselves as deviant and flawed, confuse their perceptions of hunger and satiety, and divert their attention away from other problems. Such negative consequences obviously do not occur all of the time or to all people; but they need to be given more serious consideration than they have in the past if we are to do no harm". ⁵

In Unit III: Lesson A,  these failures of the old paradigm as discussed by Garner and Wooley will be explored in detail.

References
 

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© Fall 2001