By Madeleine Oritz
The Canadian Obesity Guidelines (written with the help of 60 authors and the review of over 500,000 research studies) confirm that obesity is not something we should take on with diet and exercise alone. According to the guidelines, obesity is a chronic disease that’s caused by over 150 different genetic, metabolic, behavioral and environmental factors. With the virtually endless amounts of external factors that can influence and impact obesity, it’s no wonder experts recommend seeking professional, medical help for losing weight and keeping it off for good. But for those same reasons, diagnosing the root cause of weight gain and choosing the correct treatment can be tricky – that’s why it’s important to share a complete, obesity-centered health history when bringing up the topic with a healthcare professional. What exactly does that include? Read on to find out.
Your doctor needs to know more than your current weight – or even just the recorded list of weights you happen to be each year when you stop in for your annual visit. Give your doctor a more comprehensive picture, including the age you were when you first started gaining weight, life events where you recall a significant change in weight, previous weight loss attempts (what they were, how much weight was lost and if any weight was regained) and your current phase of weight (ie losing, gaining or stable).
It might feel like nutrition history would fall under weight history, but it’s actually so important that it needs to be its own category. Let your doctor know what a typical day of eating looks like for you – and be sure to include any incidents of bingeing or extreme restricting. Keeping a detailed food journal for at least a week before your visit can help you give your physician a clear picture. Don’t ever be embarrassed to honestly share your food intake with your doctor. They are not there to judge and knowing as much information as possible can help the two of you choose the best course of treatment together.
Though weight bias and stigma might suggest otherwise, people of all shapes and sizes exercise (or don’t exercise). Let your healthcare professional know how much time you spend intentionally participating in physical activity, how many steps you typically take in a day and how much time during the day you spend sitting at a desk or doing other sedentary activities. It is also important to include any barriers to physical activity including injury, diseases or social anxiety.
Mental Health History
Those who live with depression and anxiety are 2.5 times more likely to also live with obesity or excess weight. Even if you’ve never been officially diagnosed with depression, , anxiety or other mental disorders, it’s important to let your doctor know how you’re feeling both mentally and emotionally. And if you have been diagnosed with a mental disorder, be sure to let your doctor know about any prescriptions you are currently taking or have taken in the past – as many of these medications can also be linked to weight gain.
Addiction can occur via chemical reactions and imbalances in the brain – and many people who suffer from addiction also have obesity. That’s why it is important to let your doctor know if you smoke, use cannabinoids or other psychoactive substances (or if you’ve used them in the past), and how much alcohol and caffeine you consume and how often. This information is not to be used to judge your current habits, but instead help your doctor get a better understanding of the root causes of your weight gain and provide better treatment.
Abuse and/or Trauma
While a traumatic incident or occurrence of abuse may seem like it has little to do with your current weight, both have strong proven links to obesity. Share any incidents of physical, psychological and / or sexual abuse with your healthcare provider – even if it occurred years prior to any significant weight gain.
Good sleep is critical for successful weight management – and poor sleep can sometimes cause weight gain. When sharing sleep history with your healthcare provider, include the number of hours (on average) you sleep a night, what time you go to bed and what time you wake up, if your sleep is inconsistent or if you have frequent wake-ups and interruptions throughout the night, and if you take any sleep aids. Be sure to let your doctor know if you are a shift worker or if you’ve ever been tested for sleep apnea.
Any medications you have taken or are currently taking, regardless of why they’ve been prescribed, should be disclosed to your doctor during your health history. If you’re taking a medication “off label” be sure to let your doctor know the reason the medication was prescribed. If you take over the counter medications, vitamins or supplements, it can be helpful to include those in your medical history as well.
There can be many barriers when it comes to weight management and health so it is important to include a personal social history for your doctor so they don’t select a treatment that your lifestyle does not allow. Disclose your age, race and ethnicity, relationship status, living arrangements, occupation and even your financial status to your doctor. The information you share with your doctor is protected so be sure to be upfront and honest about anything in your life that could prevent you from sticking with or having success with your treatment.
There are over 140 gene regions that are associated with obesity- so letting your doctor know if others in your family have obesity can help him or her assess genetic factors that might be playing a role in yours. You can also include family history of other diseases, especially those closely associated with obesity, like diabetes and high blood pressure. The more information you have that can help your provider get a clear picture of your genes, the more information they’ll have about root causes and how effective certain treatments might be.
Last, but not least – be honest with your doctor about how motivated you are and how encouraged you feel about treatment and obesity management. Discuss your personal motivating reasons, how ready and willing you are to make change, what might make change difficult for you, how successful you think you’ll be and your expectations. Honesty about what you’re willing to do today prevents you from feeling discouraged tomorrow. Additionally, expressing your expectations can help you understand what a realistic goal might look like and the work it will take to accomplish.
If reading this list of things to include in your medical history has you feeling a little overwhelmed – don’t worry. It is a lot to prepare and think about! But the more work you can do before choosing a treatment plan with your doctor, the more likely you will be to find success. Healthcare providers, armed with the new Canadian Obesity Clinical Practice Guidelines, are there to help you on your path to improved health – but they aren’t psychics. Sharing as much relevant medical history as possible gives them more information – and knowledge is power. The power to create more effective treatment plans and ultimately, a happier and healthier you!
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