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Obesity Redux: The RFL Results and complex Nature of Truth and Science

August 28, 2012 By scottdm 2 Comments

Back in April, I blogged about research published by Ryan Sorrell on the use of feedback-informed treatment in a telephonically-divered weight management program.  The study, which appeared in the journal Disease Management*, not only found that the program and feedback led to weight loss, but also significant improvements in distress, health eating behaviors (70%), exercise (65%), and presenteeism on the job (64%)–the latter being critical to employers who were paying for the service.

Despite these results, the post garnered no attention until four months later during the first week of August when three clinicians posted comments on the very same day–that’s the beauty of the web, a long memory and an even longer reach.

What can I say?  I’m having to eat my hat (or, the bird on my shoulder is…).  I learned a great deal from the feedback:

  • Despite having sourced the figure from the American Academy of Child and Adolescent Psychiatry, the claim that weight gain due to poor diet and a lack of exercise was responsible for 300,000 deaths was false.  According to the comments, the figure is closer to 26,000, a mere 10% of the number claimed!
  • The same was true regarding the reported annual cost of obesity.  The 100 billion dollar figure reported on the AACAP website is, I was told, “grossly inflated” and worse, missed the point.  By focusing on BMI, the writer counseled, “we will have wasted money spent on the 51% of the healthy people who are deemed ‘unhealthy’ based on weight and the 18% unhealthy ones who are overlooked because their weight looks fine (see Wildman et al., 2008).”

Solid points both.  Thankfully, one of the writers noted what was supposed to have been the main point of the post; namely, ” the importance of “practice-based” evidence” in guiding service delivery, “making clear that finding the ‘right’ or ‘evidence-based’ approach for obesity (or any problem for that matter) is less important than finding out “what works” for each person in need of help.”

I want to make sure readers have access to the results of the study because they are an impressive demonstration of what’s possible when the feedback is sought from and used to guide service to people “in care.”  Weight loss aside, Ryan also reported significant improvements in distress, healthy eating behaviors (70%), exercise (65%), and presenteeism on the job (64%).  All this by using two simple, 4-question scales.

*Sorrell, R. (September, 2007).  Application of an Outcome-Directed Behavioral Modification Model for Obesity on a Telephonic, Web-based Platform.Disease Management, 10, Supplement 1, 23-26.

PS: An AP article that came out this last weekend and was discussed on NPR suggests the truth about the “weight of the nation” may be more complicated than either I or those who commented on my blog may realize.  Among the many changes that have occured over the last decades, the piece declares, “Who are we?  Fatter.  The average woman has gained 18 pounds since 1990, to 160 pounds; the average man is up 16 pounds, to 196.”   Hmm.

Filed Under: Feedback Informed Treatment - FIT, obesity Tagged With: American Academy of Child and Adolescent Psychiatry, Chronic Disease, cognitive-behavioral therapy, disease management, evidence based practice, icce, Weight Management

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