Barriers to address obesity
There are numerous reasons why we find it difficult to address obesity in a consultation. Very few of us would have covered obesity in our own training as the health problem is relatively new, resulting in problems with role adequacy. If we look at our healthcare colleagues, there may be very few who actively address obesity in a consultation resulting in problems with role legitimacy.
Here are some commonly cited barriers:
My patients are unlikely to listen to advice
Obese people are generally lazy and unmotivated
I don't know what to advise other than eat less and exercise more
None of my colleagues address this, it's not my job
I'm overweight myself and I would sound hypocritical
It's unrealistic to expect people to change
I don't want to offend my patients
I don't have the time or resources to address this
Barriers include:
- social anxiety about broaching this taboo topic;
- our feelings about our own weight;
- a lack of confidence in our own skills and knowledge (role adequacy)
- a lack of time, resources or referral options (resource adequacy);
- feelings of despondency and powerlessness in our ability to have an impact;
- feeling that it is not part of your job to help patients to lose weight (role legitimacy). This may be affected by role modelling, perceived social norms for your role, and your attitudes (conscious or unconscious) to obese patients
These barriers may lead to obesity not being addressed until health problems arise, and even then the advice is often simply "you should lose weight".
