Patient-Centered Care for Obesity: How Health Care Providers Can Treat Obesity While Actively Addressing Weight Stigma and Eating Disorder Risk

Cardel, Michelle; Newsome, Faith A.; Pearl, Raymond; Ross, Kathryn; Dillard, Jackson R.; Miller, Darci; Hayes, Jacqueline F.; Wilfley, Denise E.; Keel, Pamela K.; Dhurandhar, Emily J.; Balantekin, Katherine N.

doi:10.1016/j.jand.2022.01.004

Cited by 63 publications

(35 citation statements)

References 141 publications

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“…Participants were interested in detailed tips on avoiding physical activity-related hypoglycemic events, diabetes-friendly meal/snack suggestions, and discussion of how engaging in these healthy lifestyle activities can improve HbA1c. While the idea of directly discussing weight was met with some hesitation from caregivers and endocrinologists, most participants agreed that the messaging around weight should be sensitive, reduce weight stigma, increase body esteem and self-confdence, and focus more on improving health as opposed to reducing the number on the scale, which is consistent with current adolescent BLIs [49].…”

Section: Discussionmentioning

confidence: 78%

Formative Development of a Weight Management Intervention for Adolescents with Type 1 Diabetes Mellitus and Obesity

et al. 2023

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The prevalence of overweight and obesity in youth with type 1 diabetes mellitus (T1D) now exceeds that of youth without T1D. Comorbid T1D and excess adiposity are associated with multiple serious negative health outcomes. Unfortunately, youth with T1D are often excluded from and/or not referred to standard behavioral lifestyle interventions. This is often attributed to the complexities of managing T1D and an effort not to overburden persons who have T1D. Furthermore, standard behavioral weight management intervention recommendations can be perceived as contradicting T1D disease management (e.g., removing sugar-sweetened beverages from diet, energy balance with exercise, and caloric restriction). A weight management intervention specifically designed for youth with T1D is needed to provide treatment to youth with comorbid T1D and overweight/obesity. The current study interviewed adolescents with T1D and overweight/obesity (n = 12), their caregivers (n = 12), and pediatric endocrinologists (n = 9) to understand (a) whether they would be interested in a weight management intervention adapted for youth with T1D and (b) specific adaptations they would want and need. Five central themes emerged following applied thematic analysis: (1) program content, (2) programmatic messaging, (3) program structure, (4) social support, and (5) eating disorder risk. Results provide detailed recommendations for the adaptation of a behavioral weight management intervention for youth with T1D.

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Section: Discussionmentioning

confidence: 78%

Formative Development of a Weight Management Intervention for Adolescents with Type 1 Diabetes Mellitus and Obesity

et al. 2023

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“…As a CBT-ED (Cognitive Behavioral Therapy for Eating Disorders) accredited medical doctor, working with a multidisciplinary intensive outpatient unit for eating and weight related disorders, and as an active member of the international community of eating disorders specialists, I would agree with AAP regarding the importance of including many components of eating disorders management in weight management (Cardel et al, 2022) to bridge the gap between the eating disorders world and the weight management world.…”

Section: Discussionmentioning

confidence: 99%

“…This same review as well as a proposal to reduce the dichotomy between treating obesity and treating eating disorders (Cardel et al, 2022), acknowledge that maintaining long term engagement with an obesity treatment appears to be to most important contributor to the reduction of eating disorders risk, and that no study offered any feedback on the high number of children and teens who withdraw from treatment, making further research mandatory "to better understand the relationship between dieting and eating disorders risk in the context of obesity treatment for children and adolescents" (Jebeile et al, 2019).…”

Section: The Controversy Around the Risk Of Developing Or Triggering ...mentioning

confidence: 99%

American Academy of Pediatrics Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents with Obesity: What we can learn versus what we can apply in clinical practice

Chidiac¹

2023

Ijedo

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The American Academy of Pediatrics released its first guideline for the evaluation and treatment of children and adolescents with obesity, which was negatively received by eating disorders experts and anti-weight stigma activists around the world. As a primary care physician and an eating disorders practitioner, dealing with the devastating effects of both excess weight and eating disorders in kids and teens, I read with great interest the recently published guideline. A large section was dedicated to the complexity of the problem at hand, from the multifactorial causes to the long list of obstacles to treatment including the significant harm caused by weight stigma in healthcare. The main proposed management, Intensive Health Behavior and Lifestyle Treatment seemed inclusive of multifaceted components needed by kids and their families, unfortunately the feasibility, availability and affordability of such treatment are very problematic. On the other hand, the benefit-harm assessment used was quite confusing especially when it comes to eating disorders risk, and the evidence used to back up the strategies proposed was very weak. While we can learn a lot from AAP clinical practice guideline for the evaluation and treatment of children and adolescents with obesity, there is very little we can apply in clinical practice because of lack in resources and risk of doing harm.

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“…To this end, it is increasingly important to recognize that (1) obesity is a disease with clearly defined causative biological underpinnings and not a disorder of choice, laziness, or lack of personal motivation for self-care and (2) social stigmatization is harmful to individuals impacted by the disease and perpetuated by bias in medical care. To provide optimal patient care, researchers, clinicians, and the lay populous need to actively work together to combat the bias and stigma associated with obesity—minimally, by focusing on the use of person-first language along with other recommendations detailed in a recent joint international consensus statement [ 28 ] and patient-centered care report [ 29 ].…”

Section: Over/undernutrition Effects On Covid-19 and Pascmentioning

confidence: 99%

The Role of Nutrition in Mitigating the Effects of COVID-19 from Infection through PASC

2023

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The expansive and rapid spread of the SARS-CoV-2 virus has resulted in a global pandemic of COVID-19 infection and disease. Though initially perceived to be acute in nature, many patients report persistent and recurrent symptoms beyond the infectious period. Emerging as a new epidemic, “long-COVID”, or post-acute sequelae of coronavirus disease (PASC), has substantially altered the lives of millions of people globally. Symptoms of both COVID-19 and PASC are individual, but share commonality to established respiratory viruses, which include but are not limited to chest pain, shortness of breath, fatigue, along with adverse metabolic and pulmonary health effects. Nutrition plays a critical role in immune function and metabolic health and thus is implicated in reducing risk or severity of symptoms for both COVID-19 and PASC. However, despite the impact of nutrition on these key physiological functions related to COVID-19 and PASC, the precise role of nutrition in COVID-19 infection and PASC onset or severity remains to be elucidated. This narrative review will discuss established and emerging nutrition approaches that may play a role in COVID-19 and PASC, with references to the established nutrition and clinical practice guidelines that should remain the primary resources for patients and practitioners.

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Patient-Centered Care for Obesity: How Health Care Providers Can Treat Obesity While Actively Addressing Weight Stigma and Eating Disorder Risk

Cited by 63 publications

References 141 publications

Formative Development of a Weight Management Intervention for Adolescents with Type 1 Diabetes Mellitus and Obesity

Formative Development of a Weight Management Intervention for Adolescents with Type 1 Diabetes Mellitus and Obesity

American Academy of Pediatrics Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents with Obesity: What we can learn versus what we can apply in clinical practice

The Role of Nutrition in Mitigating the Effects of COVID-19 from Infection through PASC

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