Assisting patients manage their weight during the holiday season

Author: 
Dr Catherine Spooner

Written by Dr Catherine Spooner, Coordinator of COMPaRE-PHC and Senior Research Fellow at the Centre for Primary Health Care and Equity UNSW Australia.

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With the summer holiday period and Christmas season upon us, what are the implications for PHC practitioners with patients with overweight or obesity?

There is some research on the implications of seasonal variation (winter-summer), recreational holiday periods, and celebrations that focus upon eating, such as Christmas. Most of the research in this area is from the northern hemisphere, where the seasonal and holiday patterns differ from those in Australia. Recent research [1-5] suggests that weight increases over this period are:

  • generally not as large as people imagine
  • more likely among people with overweight and obese than people with a normal BMI
  • more likely to be retained among those with greater BMIs
  • less likely among those who pay greater attention to exercise, diet and stimulus control than those who don’t
  • the major contributor to annual excess weight gain.

Practice notes for patients with overweight and obesity using the 5A’s framework, as used in the NHMRC obesity management guidelines, [6] are proposed below:

1. Ask and assess

This can be a period during which patients with overweight and obesity who have not been engaged in weight maintenance might be open to doing so. In particular, many people with overweight and obesity make New Year resolutions that they fail to adhere to. [7] This could be the time to enroll your patients in a weight-loss program. [8]

2. Advise

Specific advice for weight management during the holiday season can be helpful. For example, goals for the season need to be realistic. It can be more effective to recommend weight maintenance during this period than weight loss. [3, 9] Fact sheets from reputable sources can be downloaded and provided to patients. For example, see those provided by:

3. Assist

Patient confidence and skills in self-management will be particularly important over the holiday period. This includes goal setting, self-monitoring of behavior and weight, problem solving and catching lapses before they become large-scale weight gains. Education in self-management prior to the festive season will assist patients with overweight and obesity to avoid or manage the pressures to eat, drink and be inactive.

Check that people with overweight and obesity have the support they need over the holiday period. The services to which you have referred them might be closed, or patients might be away from home on a holiday. Internet-based or telephone services such as Get Healthy (gethealthynsw.com.au) could provide the extra support needed.

4. Arrange

Schedule a review after the holiday period. For those who have achieved their goals, this provides an opportunity for positive reinforcement. For those who have not done so, this provides an opportunity to assist with motivation (if needed) and review the weight-loss plan.

References

  1. Phelan S, Wing RR, Raynor HA, Dibello J, Nedeau K, Peng W: Holiday weight management by successful weight losers and normal weight individuals. Journal of consulting and clinical psychology 2008, 76(3):442-448.
  2. Cook CM, Subar AF, Troiano RP, Schoeller DA: Relation between holiday weight gain and total energy expenditure among 40- to 69-y-old men and women (OPEN study). The American journal of clinical nutrition 2012, 95(3):726-731.
  3. Cunningham E: What's the latest on holiday weight gain? Journal of the Academy of Nutrition and Dietetics 2013, 113(11):1576.
  4. Garcia CG, Berna A, Sebastia N, Soriano JM: Prospective study on the effect of the influence of holiday periods in the weight during a low-calory dietetic treatment. Nutricion hospitalaria 2013, 28(6):2246-2251.
  5. Schoeller DA: The effect of holiday weight gain on body weight. Physiology & Behavior 2014, 134(0):66-69.
  6. National Health and Medical Research Council: Clinical practice guidelines for the management of overweight and obesity in adults, adolescents and children in Australia. Melbourne: National Health and Medical Research Council; 2013.
  7. Rossner SM, Hansen JV, Rossner S: New Year's resolutions to lose weight--dreams and reality. Obesity facts 2011, 4(1):3-5.
  8. Patterson L, Patterson C, Kee F, Hughes C, Donnelly M, O'Reilly D: Prescribing for weight loss in primary care: evidence from a population based study. Journal of epidemiology and community health 2013, 67(6):530-532.
  9. Marino C, Howk S, Domer MC: “Hold the Holidays” Participants Held the Weight. Journal of the American Dietetic Association 2009, 109(9, Supplement):A86.