30% of patients who fail to comply with the prescription of eat less, leave the diet for "shame" to confront their doctor
Fear of appointment is a major cause of treatment dropout. It happens mainly in "dependent personalities."
Data provided by Prof. Dr. Ricardo Chiosso (MP 13766), Medical Director of Diquecito Sanatorium
• "One of every three patients who discontinues treatment for weight loss in clinic, said having discontinued the trial for" shame "in front of the doctor as a result of failing to achieve the proposed results."
• "In other words, when starting a weight reduction treatment, some people give the specialists a powerful role that makes them think that they will control the situation they cannot afford. So if the new treatment fails, people tend to blame to the prescription. "
• "This cycle is growing proportionately with each relapse. The biggest problem of abandonment of the diet comes when the person realizes that there are no major differences between therapeutic rehabilitation proposals but all involve food restriction rules that they cannot fulfill, and that is when shame appears that leads them not to appear again to the professional and start looking for a new professional more tolerable to lose weight. "
• "The person becomes aware that he/she could not take the prescription, and instead of analyzing the causes of failure, people blame the diet and the doctor who prescribed it, looking for a new professional who will fill illusions until they realize it does not have to do with it. Again the guilt and shame come. "
• "Those who suffer most from this situation are those with dependent personalities, both" active dependent "as" passive dependent. "
• "Generally speaking, these are individuals who continually seek other people's value and emphasize what they do. They need a permanent guarantee by others to feel safe. Show a high need for support and attention. If they are deprived of affection and care, they experience marked distress, sadness and anxiety. "
The third and fourth week: the bottleneck
• "The dropout rate of outpatient treatment for weight loss, without hospitalization, when the patient does not achieve the desired drop (usually higher than the possible), is t hree to four weeks."
• "The first week is usually successful with the patient’s enthusiasm and dedication to fulfilling the objectives. But during the second week motivation levels decrease because of the restrictions.
• "When the person who placed their trust in a professional realizes that knowledge of this person does not give the power to solve the problem directly, leaves treatment without explanation."
• "People don’t give signs of life because in reality decide not to continue with their visits. Usually think 'just for today I will not go to the doctor', like alcoholics, and that's how this treatment is left unconsciously and go in search of another professional who may delegate entirely the problem. "
• "When the person realizes that he has failed and not his therapist, he can react in different ways. But there is a high rate of self-reproach for failing to comply with the prescription. "
• "To make matters worse, in the environment is installed a conviction of guilt to failure. It is this idea that if you are overweight is because you want it or because you are too lazy to deal with a diet or because you are irresponsible. And before the discontinuation of treatment, it is usually assumed that fault. "
How to act on social and family environment
• No pressure. "Do not pressure the person. People struggle with obesity all life, and we must help the person to change the habits. During this change of habits, you should know that failure is possible, because we will learn. "
• Do not condemn. "It is important that the family stop convicting, and then, help trying to work in different ways. For example, having a healthier diet in general (without distinction), remove from the sight tempting things. Understand that your loved one is facing an intense struggle and suffering, and usually the family has helped the patient to swallow things instead of talking. "
• Be interested. "It is important to understand that, whether taking or not a professional treatment, the person has the disease. In this context, we must support our loved one to accompany the consultation as if I were to be any type of medical study. So you have to be with him/her, care and help to stick to the diet. "
• Educate. "To convey the idea that there are no big secrets in this to lose weight, and that everything depends on being able to change habits. Help the person understand that the key is to eat everything in smaller quantities, more organized, to incorporate physical activity both formal and informal, among other things. "
The advantages of placement to reduce early
• "Placement in order to lose weight is an ideal choice, since one has night and day care professionals of all specialties not only helping to advance the performance of the diet but also encouraging the practice.