Saturday, August 7, 2010

Putting Healthcare Practitioners On A Diet

Cotugna N, Mallick A. "Following a calorie-restricted diet may help in reducing healthcare students' fat-phobia." J Community Health. 2010 Jun;35(3):321-4.

Department of Health, Nutrition & Exercise Sciences, University of Delaware, 301C Willard Hall, Newark, DE 19716, USA.


Data from National Health and Nutrition Examination Survey 2005/2006 show that 32.7% of US adults are overweight (BMI 25.0-29.9), 34.3% are obese (BMI 30-39.9), and 5.9% are extremely obese (BMI >or= 40). For the first time, the number of obese American adults is greater than those who are merely overweight. Negative attitudes and fat phobia toward the overweight exist not only in the general population, but also among health professionals including dietitians and dietetics students.

The purpose of this study was to determine if fat phobia might be reduced among future professionals by putting students on a calorie-restricted diet for a short period.

Forty dietetics and health promotion students enrolled in a university obesity course completed the Fat Phobia Scale test before and after following a calorie restricted diet for 1 week (1,200 calories and 1,500 calories for women and men, respectively). Students also reflected their thoughts about following such a diet via brief journal entries.

Results showed the change in fat phobias after following a calorie-restricted diet was significant. Many journal entries reflected a newfound respect for individuals struggling to lose weight and change in prior negative attitudes. Students reported that this experience would impact their future dealings with overweight/obese clients.

It may be useful to incorporate this type of activity into the training of nutrition and other health professional students to increase sensitivity and reduce existing biases and negative attitudes toward overweight/obese clients.

PMID: 20130971

**Personally, I think the dietetics students in the abstract above should have had to follow the 1200/1500 K diet for a lot longer than a week to see how it REALLY feels. A week is nothing; it's the long-term regimen that really takes its toll.

I don't have the citation for it anymore, but long ago I remember reading a study where diabetes education specialists were required to exactly follow a diabetes self-care regimen, including eating restrictions, self-measuring blood sugar 3-4x per day, completing exercise requirements, and to mimic taking medications on schedule.

They failed miserably.  It was a good lesson in patient compliance.  They gained new perspective into how demanding such self-care regimens can be, why patients don't always adhere 100% to them, and obtained new empathy for the stress of dealing with chronic healthcare concerns.



Miriam Heddy said...

I agree that a week isn't long enough to understand it if you haven't been a participant. But I also wonder what the gender breakdown was in that study. Women are socialized into both fat talk and calorie consciousness as normative behaviors, whereas men are not. So I would figure that it'd be a great deal odder for men than for women to participate in it.

I also wonder if there was any care taken in terms of the ways it might be triggering.

Anonymous said...

Well at least it is a start:) better the nothing ugg. I guess I am susprised that so many people need coaching in empathy and it isn't more ingrained...but in a way I guess I'm not susprised either.
That should be a whole year in medical school.....a semester of empathy training, bedside manner, humanity.....etc

Anonymous said...

and they also should have made them exersize for an hour daily yoo, as we on "diets" are supposed to do to meed the calorie in calorie out requirement.

LisaB said...

This is really valuable information for health care providers, but I don't know if following it for a longer period would be good for them healthwise. How many eating disorders might we trigger just because we want them to know how it feels?

Unknown said...

It bothers me how easily we expect others to diet. I've personally been through a period of my life when I was eating that little and it was painful physically and mentally. I never wish others to go through that.

I hope you don't mind the link but I commented more on this study over at my blog:

Anonymous said...

This strikes me as quite a brilliant idea. "Walk in my shoes" (or at least, mimic what it might kind of be like). The most sympathetic doctors I've had have been ones who were/are heavier themselves. My dad is diabetic and found that a nurse who was herself diabetic was the most understanding.

I wonder what percentage of the nurses I've had over the years who were kindly about administering vaccines (as opposed to "This doesn't hurt/it only takes a second/why are you so scared?") were themselves needle-phobic.