When traditional approaches don't work - what does?
Helping people to manage their weight requires a different approach in practice
Tackling obesity is practically and philosophically different to taming an infection
The celebrated French philosopher Voltaire evaluated the practice of medicine as:
"Doctors…prescribe medicines of which they know little, to cure diseases of which they know less, in human beings of whom they know nothing."
Now in the 300 or so years since Voltaire made his evaluation, the practice of medicine has improved significantly. Clinicians generally have a much better understanding of how to treat diseases or ‘conditions’… as long as those conditions have a clear physical etiology (cause). However, Voltaire’s evaluation still appears credible when we consider conditions with a behavioural etiology.
Take diabetes as an example.
Type I diabetes (insulin-dependent diabetes) is an auto-immune condition where the pancreas produces little or no insulin. People with type I diabetes are dependent on daily injections of insulin to regulate their blood sugar levels, and to put it bluntly, survive.
Type II diabetes (non-insulin dependent diabetes) is quite different. While it shares physical symptoms such as the inability to regulate blood sugar levels via the action of insulin, the condition develops as a chronic response to a poor diet and physical inactivity. Hence, it is known as lifestyle diabetes.
Approximately 10% of adults with diabetes have type I diabetes. The condition has a clear physical etiology (cause) which is now effectively controlled through medicine. Type II diabetes is a far greater problem in the western world; more and more people develop the condition and treatments are far less effective than those used for type I. Part of the reason for this is due to our preference to treat conditions that have a clear behavioural etiology in the same way that we treat conditions with a physical etiology. This preference applies to treatments for obesity also.
To a hammer, all things must be nails
Clinicians who classify their clients as suffering from a disease search for a drug based cure because most diseases have a physical etiology that is best treated with medicine. Under this treatment model the authority for treatment is awarded exclusively to the clinician. The recipients of the treatment (the ‘clients’) are passive; their only involvement is to follow the dictate of the clinician and take their medicine as prescribed.
When a condition is the product of maladaptive behaviours, clinicians (ideally) utilise therapies that help people to suppress those behaviours and substitute them with healthier alternatives. Under this model, clinicians help people to alter their behaviour and the authority for the treatment is sharded between clinician and client.
The least common treatment model arises when peoples conditions are believed to emanate from their own interpretations of their unique life experiences. Under this model, clinicians encourage their clients to rethink their understanding of their condition and its causes; the client is encouraged to take a leading role in the treatment process.
Now these different treatments models are all well and good, but how do they apply to treatments for type II diabetes and, obesity?
Flawed understanding underpins failed weight loss models
Type II diabetes and obesity are first and foremost conditions with a behavioural etiology. Unfortunately, they are seldom treated as such. Many clinicians value the simplicity and kudos that can be gained from treating these conditions as if they had a simple physical etiology; it feels good to tell others what to do and appear knowledgeable at the same time. Hence, diets, diet pills, supplements, meal replacements and exercise programmes are prescribed just as a doctor prescribes medicine.
No matter how appealing these treatments may be, they ignore the primary etiology of the condition (obesity and type II diabetes) and as such, are doomed to fail.
Unfortunately, treating conditions with a behavioural etiology as they should be treated, is not appealing to many clinicians. Behaviours are seldom simple, they are often complex, and usually influenced by multiple factors which vary from person to person and are often hard to control. As such, behavioural treatments require the active and equal input of the client in the treatment process; this reduces the ability of the clinician to bask in the glory of being able to ‘cure’ another person via their individual expertise.
Others know best is not always true
For the popular treatment of conditions such as obesity and type II diabetes, Voltaire’s evaluation is not far from the mark. Treatments are often ill-suited to conditions for which the true etiology (cause) is poorly understood, and the ability of clients to take an active and sometimes leading role in the treatment process is seldom considered let alone encouraged.
In contrast to most treatments for obesity and type II diabetes, Weight Management Coaches practice from a behavioural model where the authority for treatment is shared between client and coach, and clients are often encouraged to take a leading role in their treatment. Weight Management Coaches understand that behaviour is influenced by a variety of biological, psychological, societal, and not least environmental factors, all of which must be understood and addressed in the treatment process. Clients are encouraged to understand how their behaviours are manipulated by the pervasive influence of food marketing and the production of products loaded with habit forming ingredients. Coaches work collaboratively to help clients identify and implement sustainable solutions to the unique mix of factors underlying their condition.
As opposed to those who understand and treat obesity (and type II diabetes) as a simple physical condition, Weight Management Coaches understand the variety of factors that influence weight and weight-related behaviours, they understand how to treat these from a behavioural model and utilise the expertise of the individuals they help in the process.
Sadly, Voltaire’s evaluation still applies to those who treat conditions such as obesity with diets, diet pills and meal replacements. Fortunately, there is a kinder and more permanent approach now available through Weight Management Coaching.