Participants accurately described the health and social risks
of obesity. They listed several benefits of losing weight, especially
avoiding diabetes and hypertension. The benefits of being
at a healthy weight and even losing just a few pounds
should be stressed (28-30). Several women said their weight
limited them from living life to the fullest, made them embarrassed
to shop for clothes, and made them the subject of jokes.
It is important to show empathy when clients describe their
negative social experiences with their weight. Obese women
experience high levels of frustration, body dissatisfaction,
weight ideation, stigma, and discrimination because of their
weight (6). They also express feelings of constant hunger and
deprivation, shame, and body hatred (31). Some women will
be motivated to change solely for appearance and this can be
used as a starting place for change with clients.
Regular physical activity is necessary for long-term weight
management and studies consistently show that African
Americans do not meet the national recommendations (32).
Lack of time was cited as a major barrier. Working mothers
can feel especially guilty about taking time for themselves
because they also experience social pressure to devote their
spare time to their families (33,34). Given the importance of
physical activity, emphasis needs to placed on setting realistic
goals, participating in family-centered activities, and exercising
with a buddy (3). Frequent, short intervals of activity are
recommended for heavy women and those starting an exercise
program (32,35).
Because many individuals are motivated to make lifestyle
changes only when they or a family member are diagnosed
with a health problem (4,36), it is important to discuss other
indicators of an unhealthy weight, such as lack of energy, fatigue,
and tight-fitting clothes. Tying these indicators to a
family history of diabetes, hypertension, and heart disease
can provide added motivation to get to a healthy weight.
Self-efficacy is integral to weight-management success. Dietetics
practitioners can help foster self-efficacy through positive
reinforcement and acknowledging small behavior
changes. They can also encourage clients to join a support
group, sign a health contract, and use positive thinking and
daily affirmations (37). A depression questionnaire can also
help to identify clients who might need referral to a therapist
(38). A culturally tailored program can also increase self-efficacy.
Tailored program are usually effective because clients
are more likely to scrutinize and personalize the information,
thereby increasing the likelihood of change (38).