Supporting Patients / Clients
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Opening up a conversation with a patient about their weight warrants sensitivity and insight into the individuals personality. It is difficult to capture the ideal dialogue to fit all types of personalities, and only you can really determine the best way to approach and discuss the topic in a way that reflects sensitivity and empathy to what they are feeling, and what their individual circumstances are. We have taken an exerpt from an article by Dr. Debra Katzman, of The Hospital for Sick Children, that captures some key concepts and suggestions for how Physicians can open a conversation about body image satisfaction. Young girls at risk of an eating disorder never feel they are thin enough. They often describe some part of their body as too ‘big’ or ‘fat’. These girls resist gaining weight. As a girl continues to diet and her body becomes thinner, she remains critical of her shape and weight. In one series of 48 anorexic children under 14 years old, 56% expressed a dread of fatness (Fosson, Knibbs, Bryant-Waught, & Lask, 1987). Assessing the patient’s satisfaction with her body and her perception of body shape and size is therefore important. |
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The physician might begin by exploring whether there is anything about the patient’s body (size, shape, weight) that she wishes she could change? What does she see when she looks in the mirror? A response indicating body dissatisfaction (“I really dislike my body”) or disturbances in the way she experiences her body e.g., “my stomach and thighs are huge?”) warrants further exploration. The physician might probe into the relative importance of the young person’s body and shape, weight and size in the overall way she feels about herself. Does the patient believe that her life will change as a result of weight loss? We ask all our patients what they think is their ‘ideal’ body weight. If a young person reports that she is dissatisfied with her body then it is important to explore how she copes with these feelings. “How do you deal with the feelings?” “Have you tried to adjust your weight?” “How have you tried to lose weight?”
Prevention of Medical Complications in Children and Adolescents with Eating Disorders. Dr. Debra K. Katzman. Piran, N, Levine, M.P., Streiner-Adair,C. (1999). Preventing Eating Disorders: A handbook of special challenges. (304-318). Philadelphia, PA: Taylor and Francis. Reprinted with Permission
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