Watching Weight: The New Tool to Help DCs and Their Patients

Remember when Dr. David Seaman labeled obesity the "elephant in the COVID-19 living room" (January 2021 issue)? He connected the dots between obesity and poor coronavirus outcomes during the global pandemic, but your patients' weight is truly the perpetual elephant in the room. Pandemic or no pandemic, it is the increasingly concerning, but still underdiscussed and underaddresssed, topic in clinical practice – including chiropractic.

In the first two articles in this series, I focused on how your patients – and you, their doctor of chiropractic – can use their smartwatches to help optimize balance and posture (January issue) and sleep wellness (March issue). Now let's discuss how you can – and should – be helping every overweight and obese patient using the same technology on their wrists.

As noted above, we'll use the Apple Watch 6 as our smartwatch example, as has been the case throughout this series.

Tracking Activity

As referenced in a previous article, the Apple Watch includes an activity app that allows wearers to track daily movement / activity, including number of hours standing for at least one minute, time spent exercising and calories burned. Each of these variables is presented in the form of an activity "ring" that progresses throughout the day, encouraging the user to "close" the ring by day's end.  At any time, the user can see how much of a given ring they have closed.

Settings in the activity app allow users the option of being reminded when to stand; daily coaching (notifications that help complete daily goals in the above categories); and even the ability to share – a great motivational tool for patients that allows them to receive a notification when a weight-loss partner closes all three rings, finishes a workout or earns an award. (They can also send similar notifications to their weight-loss partner – and to you, their doctor of chiropractic.)

The Apple watch also lets users track their activity (running, walking, rowing, stair-stepping, yoga, and a host of other activities) in real time while tracking distance, calories and time. That data syncs with the activity app to help users complete their activity rings.

Of course, patients can also download any activity app to their phone and mirror it on their smartwatch. For example, downloading the "Map My Run" app allows users to track variables such as distance, average pace, duration, route, estimated calories burned and more in real time; and compare data to previous workouts. And it's not just for runners; apps such as these can also track walking, cycling, treadmill running, etc.

If the patient's smartwatch is cellular-enabled, they can even track these activities without their smartphone nearby; just strap on the watch and hit the open road / trail / treadmill. Many of these apps also include audio coaching / encouragement, goal setting and the ability to review statistics for the week, month, etc.

Tracking Diet

Physical activity isn't the only component of successful weight loss, of course, which is why apps dedicated to tracking diet and nutrition abound. The Apple Watch doesn't offer any built-in diet / nutrition features (although it does sync with any audio books patients download to their phone, including books that help educate / motivate them on nutrition and weight loss). However, a multitude of downloadable apps are available that can help users track their caloric and nutritional diet intake.

MyFitnessPal, MealPrepPro, Foodvisor Calorie Counter and more will provide your patients with around-the-clock education and advice on what they're eating, what they should be eating more (and less) of ... and why it matters.

Tracking Lifestyle

Lifestyle considerations beyond exercise and diet also influence weight, which is why some of the Apple Watch features discussed in previous articles – notably standing and sleep – deserve mention in the weight-loss conversation. Because the Apple Watch reminds patients to stand periodically throughout the day, it reinforces a pattern of movement that can make them more likely to move in general.

Standing up and walking around for a minute every hour doesn't burn many calories, but it makes movement a recurring activity that could make patients more likely to participate in sustained, vigorous movement (i.e., exercise). No "stay in your chair or on the couch" reminders or awards here!

The Apple Watch's ability to track sleep also serves to facilitate weight loss in this simple sense: Poor sleep habits breed poor dietary habits. Not getting enough sleep makes patients more likely to consume more calories (for example, because they're up late and end up snacking at 2 a.m.) or put their diet plans on hold (because they "don't have the energy" to prepare a healthy meal / track their calories). In fact, research suggests poor sleep negatively impacts metabolism, and increases hunger / appetite.

Poor sleep also makes your patients tired and irritable – which increases the odds they'll forgo their scheduled workout(s) to catch up on lost sleep, or just rest and relax after the previous night's sleep debacle.

The Chiropractic Connection

If you believe in health and wellness (and I know you do), helping patients achieve a healthy weight, and maintain it for a lifetime, is a responsibility you're more than willing to embrace. Excess weight increases musculoskeletal pain and postural alterations; can make evaluation and adjustments more challenging; and of course, increases disease risk including type 2 diabetes and some forms of cancer. In short, excess weight jeopardizes your wellness care from day one if not addressed.

Fortunately, the often-awkward conversation about weight that makes many practitioners essentially ignore their patients' weight doesn't have to be awkward anymore. While a few questions on your new-patient intake form (1. "Are you satisfied with your current weight from a health perspective?" 2. "If you answered no to #1, would you like assistance losing weight in a safe, long-term fashion?") is a great start, it's only the beginning.

In fact, with patients increasingly tracking weight-loss variables (movement, diet, calories, etc.) using their smartwatches, doctors of chiropractic can help motivate them to pursue weight-loss activities – and monitor their progress – without the need to directly engage them in "weight-loss" conversations.

After all, if you can motivate a patient to eat better, get fitter and live healthier, the issue they've been burdened with – their weight – likely won't be an issue for long. It's time to help every overweight or obese patient. Chiropractors can and should take the lead, with smartwatch technology an important tool to do just that.