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Weight Management Through Psychology

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Executive summary

This report draws attention to the current remedies used by Raffles Medical Group (RMG) to deal with obesity – standard consultations and surgical treatments – and how they are ineffective as the obesity is still prevalent in Singapore.

This report also provides recommendations to improve the existing remedies in RMG to curb adiposity in Singapore. The recommendations are: creating a weight management package and instilling a more empathetic approach in their treatments.

The report includes the benefits of these recommendations to RMG. The benefits include allowing RMG to gain a better reputation in Singapore healthcare system, and attracting more obese patients to seek treatment in their hospital thereby leading to increased revenue.

Introduction

Rising obesity rates have posed a huge problem in Singapore, as obesity brings about severe health detriments. One viable method to prevent obesity is when people manage their weight effectively, through means such as controlling their calories intake and exercising (Goh & Pang, 2012). Such efforts, however, are hindered by the external factors of obesity such as lower prices of unhealthy food (Tomer, n.d). This is further aggravated by the bad behavioral patterns of individuals due to their low endowments of personal and health capital as depicted by Tomer (n.d).

According to Tomer, “[Personal capital]…reflects the quality of an individual’s psychological, physical, and spiritual functioning” while “[h]ealth capital…is a stock consisting of the accumulated individual learning that contributes to his…physical health and some aspects of mental health” (n.d). These factors determine how individuals react to external causes of obesity (Tomer, n.d). As such, improving these capitals and subsequently changing the behavioral patterns of obese individuals will help manage their weight effectively thereby reducing obesity rates (Tomer, n.d; Foster, Makris and Bailer, 2005).

To induce these changes, proper counseling and therapies need to be provided to patients (Foster et al, 2005). Although some hospitals in Singapore such as Singapore General Hospital (SGH) are already implementing such measures (Singapore General Hospital [SGH], 2011), most are not doing so and this includes our company, RMG. Therefore, this report aims to discuss the importance of implementing proper counseling and therapies to their existing obesity packages. It will also include the feasibility and benefits of these implementations.

1. Current remedies

In Singapore, the majority of healthcare providers play their part by offering surgical treatments and consultations for obese patients (Sim, 2011). These consultations mainly involve telling patients the proper diets and amount of exercise needed to effectively manage their weight (Sim, 2011; Foster et al, 2005).

1.1. Effectiveness

According to statistics provided by the National Health Survey (NHS), the amount of obese people in Singapore have been increasing from 2004 to 2010, the sharpest increase being people age 30 to 39 – from slightly over 4% in 2004 to over 12% in 2010 (Goh & Pang, 2012). This shows that the measures implemented by the majority of the healthcare providers are not working and there is a need for new strategies to be in place.

However, there are some healthcare providers, such as SGH, that used a different approach with obese patients. These hospitals offer consultations similar to counseling sessions. They do not just tell the obese patients how to manage their weight but guide them. For instance, having dietitians to accompany them to supermarkets to read food labels (SGH, 2011; Sim, 2011). This has proven to be effective with at least 10% of SGH’s patients losing at least 5% of their weight after three months (Sim, 2011).

1.2. Reasons for ineffectiveness

Although surgical methods to treat obesity have proven to be effective with 95% of RMG’s patients losing more than 10% of their weight in six months, these surgeries are only applicable to those considered dangerously obese (Sim, 2011). These treatments are also extremely costly and might come with side effects such as mild deficiency in Vitamin B thus not every obese patients can go through such procedures (Tomer, n.d; Sim, 2011).

The standard consultations that offer advices to obese patients about weight management are also failing. Obese patients usually know the standard weight management protocols so by advising them on these issues will not help (Foster et al, 2005). Furthermore, when patients apply the weight management methods given to them and do not see results, they might eventually give up, or proceed to eat even more which would worsen their already obese state (Donaghue & Clemitshaw, n.d; Foster et al, 2005). Consultations that took on a different approach, however, as in the case of SGH, showed more effective results.

2. Industry

The burden for coming up with better healthcare measures lies on the healthcare providers (Tomer, n.d). As seen above, the measures implemented by the majority of the healthcare providers – surgical treatments and standard consultations – are ineffective in resolving the issue, thus the need to have new implementations in place.

Surgical treatments, although limited in their capacity to treat all obese patients, have shown tremendously positive results in treating severely obese patients and thus are still important aspects in weight management (Sim, 2011).

Standard consultations offered by most healthcare providers including RMG, on the other hand, can be further improved in order to achieve greater results in managing the crisis (Foster et al, 2005). This is seen in the case of SGH where consultations focusing on educating the patients how to monitor their weight in an environment that promotes otherwise show greater effectiveness in helping the patients manage their weight (Foster et al, 2005; Sim, 2011).

3. Recommendations

Changes need to be made to the standard consultations given by RMG to their obese patients so as to help them manage their weight more effectively. This is because most, if not all obese patients have already heard about the standard practices of weight management and probably tried them before without success (Foster et al, 2005; Donaghue & Clemitshaw, n.d).

Consultations should emphasize on changing the behavioral patterns of obese patients and subsequently helping patients cope with the growing external factors of obesity (Foster et al, 2005; Tomer, n.d). These consultations should also take on a more empathetic approach to encourage obese patients to continue attending the consultations and apply the solutions taught to them (Foster et al, 2005). This is due to the fact that obese patients are usually more sensitive to comments given by others regarding weight issues and misunderstand the kind intentions from those who genuinely mean them well (Donaghue & Clemitshaw, n.d; Foster et al, 2005).

In view of these, improvements to the current weight management measures come in two aspects:

1. Offering a comprehensive weight management package.
2. Personnel involved in the treatment process to adopt an empathetic approach.

3.1. Weight Management Package

As seen in the case of SGH, offering a comprehensive weight management package yields immense results in weight management for the obese patients (Sim, 2011). This package should include consultations with specialists that teach obese patients how to overcome the growing factors of obesity in our environment thence improving the health capital of obese individuals and allow them to make better decisions (Foster et al, 2005; Tomer, n.d). For example, RMG can get one of their dietitians to educate obese patients how to properly scrutinize food labels in supermarkets (SGH, 2011).

The weight management package should also include the true purpose of weight management – to prevent obesity-related illnesses and not solely for aesthetic purposes. By understanding the purpose of weight management, obese patients will not expect unrealistic goals from their weight management efforts and it prevents them from being demoralized thereby improving their personal capital (Foster et al, 2005; Donaghue & Clemitshaw, n.d; Tomer, n.d). This is important because according to Foster et al, “[n]egative thoughts frequently are associated with negative outcomes…individual who overeats…proceeds to eat even more secondary to feelings of failure and hopelessness” (2005) and it is also shown by Donaghue and Clemitshaw that many people gave up on their weight management plans because it did not help them achieve the bodies they wanted (n.d). By understanding that it is for their own health, they will look forward to more attainable results such as lowering of blood pressure hence preventing dejection.

3.2. To adopt a more empathetic approach

With reference to Foster et al (2005), obese people are very sensitive when it comes to weight matters and if practitioners are not careful when dealing with these patients, the patients might stop coming to consultations. Donaghue and Clemitshaw also pointed out that overweight people tend to misunderstand the intentions of others when they talk about obesity regardless if they are genuine or not (n.d). All these facts point to show that it is of essence to instill a more empathetic approach when treating obese patients. An example would be instead of telling the patients that there are no improvements in their weight, doctors can enquire the reasons for their failures and come up with solutions to help them overcome their problems (Foster et al, 2005; Goh & Pang, 2012). This will allow the obese patients to feel reassured that they are not being judged and that the doctors genuinely want to help them. Such positive feelings will urge the obese patients to follow up on their consultations (Foster et al, 2005).

4. Benefits to company

The recommendations described above have shown positive results in the healthcare providers that implement them. Hence, if RMG follow the recommendations, RMG will stand to gain a substantial amount of benefits.

Successful weight management for the obese patients in RMG would mean that RMG played its part in managing the obesity crisis. This goes in line with RMG’s mission of enhancing health and well being of people. Besides, the positive results will reflect well on the reputation of RMG as healthcare providers.

Positive results will also attract more obese patients seeking for help to manage their weight thus allowing RMG to play an even greater role in managing this crisis as well as accruing more revenue.

5. Feasibility

Feasibility should not be an issue because the company will simply be tapping on resources that they have – standard consultation services. RMG just need to change the approach they are taking regarding the consultation services to a more empathetic one. The doctors and practitioners in Singapore are trained to give such counseling sessions to obese patients so applying it should not be an issue at all (Goh & Pang, 2012).

The weight management package requires professionals in different sectors such as dietitians and physiotherapists, which RMG already possess. With proper planning and arrangements of the patients’ appointments with the various specialists, this recommendation would be feasible.

6. Conclusion
In view of how pressing this crisis is, more people will be seeking help to manage their weight hence preventing obesity. With the high success rates of the above recommendations in other hospitals, RMG will definitely attract these patients and benefit from it. 7. Appendix
Raffles Medical Group (RMG) was founded in 1976 and have expanded to become one of the leading medical group and largest private group practice in Singapore. The group owns and operates a network of family medicine clinics, one tertiary care private hospital, insurance services and a consumer healthcare division.

Raffles Hospital is RMG’s flagship and it offers a full complement of specialist services combined with advanced medical technology. With twenty-one specialist centers to meet a wide variety of medical needs, Raffles Hospital is capable and prepared to face any healthcare challenges.

RMG’s mission is to enhance health and well being by providing the best total healthcare and their vision is to be people’s trusted partner for health. Their core values include: compassion, commitment, excellence, team-based care and value. RMG also has a quality policy, which is to assure the best outcome, build seamless service, create value and delight with personalized care.

8. References
Tomer, J. F. (n.d). Stemming the tide of obesity: What needs to happen. Journal Of Socio-Economics, 42, 88-98. doi:10.1016/j.socec.2012.11.001 Retrieved from http://ac.els-cdn.com/S1053535712001138/1-s2.0-S1053535712001138-main.pdf?_tid=34cc7504-e77d-11e2-bed9-00000aab0f02&acdnat=1373253751_81508f91abbd58c5b77561f3887b6be8 Retrieved on 4th Oct 2013.

Donaghue, N., & Clemitshaw , A. (n.d). ‘I'm totally smart and a feminist…and yet I want to be a waif’: Exploring ambivalence towards the thin ideal within the fat acceptance movement. Women's Studies International Forum, 35(6), 415-425. doi:10.1016/j.wsif.2012.07.005 Retrieved from http://www.sciencedirect.com/science/article/pii/S0277539512001069? Retrieved on 4th Oct 2013.

Foster, G. D., Makris, A. P., & Bailer B. A. (2005). Behavioral treatment of obesity. American Jornal Of Clinical Nutrition, 82(1), 230S-235S. Retrieved from http://ajcn.nutrition.org/content/82/1/230S.full Retrieved on 4th Oct 2013.

Sim, M. (2011). Fat No More. The Straits Times. Retrieved from http://www.healthxchange.com.sg/News/Pages/Fat-No-More.aspx Retrieved on 24th Oct 2013.

Goh L. G., Pang J. (2012). Obesity in Singapore, prevention and control. The Singapore Family Physician, 38(1), 8-13. Retrieved from http://www.cfps.org.sg/sfp/38/381/SFP%20Vol38(1).Unit1.pdf Retrieved on 24th Oct 2013.

Singapore General Hospital (2011). Obesity Management. Retrieved from http://www.sgh.com.sg/Clinical-Departments-Centers/LIFE-Centre/services/Pages/obesity-management.aspx Retrieved on 24th Oct 2013.

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