To help you enhance your practice and increase your bottom line, we ask practicing doctors of chiropractic like you for ideas and solutions that have been tested in the real world. In this issue, we asked this question: "Obesity has become a national health disaster. What is your most effective method for helping your patients lose weight?" Here's what your peers had to say about how they help overweight / obese patients lose weight and keep it off.
Setting the Example
The bottom line is all about accountability, according to Denise Chranowski, DC, from Newton, Pa.: "You need to be able to provide that to your patients. It's no longer sufficient to hand out a sheet of exercises or a diet 'to follow.' It won't get the job done. If you truly are passionate about getting your unfit and overweight patients healthy, then bring all the solutions within your four walls. Dietary counseling and follow-up, on-site personal training, walking your walk and looking the part, a proven reproducible system and measurable pre-and post-biomarkers. All of these are elements of a successful [weight-loss] program."
Daniel Batchelor, DC, who practices in Roswell, Ga., sets the example by exercising with his patients. "Exercise for a lifetime for the obese patient will only work if you can help them develop an inner love for it. My office is located next to the river with a lot of biking and hiking trails. Three times a week, I exercise there with many of my patients. I try to keep it fun for them by mixing it up each day; one day hiking, the next day kayaking and then next day biking. Research shows that nagging someone to exercise does not work, but if you just tell them every day how good exercise makes you feel, they tend to want some of that 'drug' also.
"Exercise is a positive addiction and if you can get them to the point where they become addicted to it, then you have accomplished your task. That means you must help motivate them to exercise to a point where their body begins to produce the endorphins. Endorphins are released during long, continuous workouts when the level of intensity is between moderate and high and breathing is difficult. This also corresponds with the time that muscles use [all] of their stored glycogen. Treating the obese person requires diligent monitoring and a variety of motivation methods that keep it fun and addicting."
Richard Bend Sr., DC, from New Baltimore, Mich., believes that "if the patient will take a small ring binder home and write down everything they consume for a week and share it with me, I can help identify patterns and taboos to their weight problem. I also council them that all the diet gurus have one thing in common: the consumption of water in its purest form in great amounts. I also ask [my patients] to begin to move instead of sitting around all the time. Walk, swim, bike, dance, even if you have to dance with the broom."
Educating Patients
Several doctors believe that educating patients about the importance of regular, healthy meals, as well as diet and exercise, is a pivotal element of weight-loss success. Brian Lonsdale, DC, from Alaska, tells his patients to "have a decent breakfast, including carbs, fats and protein. Calories taken on in the first part of the day can be burnt off, whereas not so easily at the end of the day."
Mark Lopes, DC, from Calif., says that "discussing a healthy eating approach in my new-patient orientation as a part of the focus on overall healing, as well as the chiropractic-specific information. Also, sending out a bimonthly newsletter that includes an easy and healthy recipe."
Many doctors under-stand that in many cases, the weight-loss battle has been a decades-long fight. Jared Leath, DC, from Arlington, Tenn., thinks "patients interested in weight loss have been part of our practice from the very beginning. There is a big difference between someone interested in weight loss and someone who is motivated to lose weight. An e-mail newsletter can set the stage for weight loss with articles about the dangers of obesity and related health problems. Positive messages are equally important to print, such as success stories to motivate patients. Healthy recipes can be great, but be sure the doctor actually uses these so [they] can have an idea on preparation and tastes."
Steve Bennett, DC, from North Little Rock, Ark., believes that "first and foremost, there is not a one-size-fits-all when it comes to weight loss. Each person has to be assessed for their particular needs. Today, our society consumes vast amounts of food, most of which is devoid of vital nutrients and enzymes our bodies need. So, most people are malnourished but yet overweight. An exercise program has to be developed based on each patient's capabilities. Often, lab work is a vital component so the overall health of the patient can be monitored as they lose weight."
And Ryan Knight, DC, from Denison, Texas, echoes the value of education: "We spend a lot of time working with and educating our patients about healthy options and weight maintenance."
Trust and Respect
Victoria Snelling, DC, from Kentucky, feels that the best way to help patients is through trust and respect. "It's most important to accept and respect patients who are overweight or obese. I find that an accepting attitude opens the door to the patient eventually bringing up the subject of weight loss.
"When that trust is established, we can have a sensible, non-resistant conversation about diet and supplements that can lead to lifestyle changes and permanent weight loss. The attitude of the caregiver is most important."
