Obesity in the Digital Age: Let's "Scale" Back the Misinformation

This article addresses the ongoing obesity epidemic. It comments on how the internet is riddled with harmful and misleading health information when it comes to weight loss advice and discusses basic steps nurses can take to to begin their weight loss journeys.

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Obesity in the Digital Age: Let's "Scale" Back the Misinformation

There is no question that in today's digital age, the sheer quantity of health information available online can be confusing to sift through. With ever-increasing rates of obesity in the West, having trustworthy information on how to not only lose weight, but also successfully maintain weight loss is of paramount public health importance. Type a quick search into Google along the lines of "how to lose weight,” and one is met with a litany of different fad diets, workout programs, and nutritional supplements that claim to be the magic answer to your weight management woes. And unfortunately, some of these tips for weight control are not only just plain wrong, they are also potentially dangerous. Ever heard of a "healthy,” "gut restoring" juice cleanse? Well, I have, too. And for your sake as well as mine, I implore you NOT to do it!

This need for better weight loss guidance is even more prominent now that we have started to emerge from the COVID-19 pandemic. One Harvard University study published in January of 2022 found that about 50% of people surveyed responded that "yes,” they had gained weight during the COVID-19 pandemic lockdown. Add those extra pounds onto an already overweight/obese population, and I'm sure you can imagine how dire of a situation this has become since we know that obesity increases the risk for virtually all chronic health problems, including diabetes, hypertension, heart disease, and more.

So, how can we help ourselves and our patients?

Firstly, skip Dr. Google today. Second, call your primary care provider (PCP) to make an appointment. As a nurse practitioner who currently works in primary care, I love when patients of mine come in requesting to specifically talk about weight management. And as an aside, if for some reason your PCP doesn't feel like engaging in a conversation about this, then I would say it's about time to get a new doctor.

But getting back to the point. Your PCP is your starting point for any and all of your health concerns. Obesity is a serious medical problem, and this is something that a PCP can help you with. Most PCPs will generally recommend a healthy diet and exercise program, and of course, this is the mainstay of "treatment,” regardless of whatever other interventions or therapies are deemed appropriate for you. Your PCP can also refer you to a nutritionist or dietician to discuss what exact diet modifications may be suggested to help you achieve your weight goals. If all your PCP says is, "eat more fruits and veggies, increase lean protein, and limit carbs,” they are really doing you a disservice even though what they are saying is technically sound weight loss advice. This is because those suggestions are going to look different for people individually since each person is unique in their dietary preferences, budget, and culture, all of which affect food choices. Your PCP, in conjunction with a licensed nutritionist or dietician, is therefore going to be the best resource in formulating a realistic, sustainable, and unique eating plan for you. Furthermore, I always ask patients do you know how to read a food label? Do you know what a basal metabolic rate is? Do you understand the concept of a calorie deficit and why this is important to achieve and maintain weight loss? Filling these knowledge gaps is so incredibly important in empowering people to take charge of their weight loss journeys. And if you are reading some of these questions, even as a nurse, and find yourself saying, "I don't know,” you are not alone.

Some second line, additional weight-loss therapies may include medication therapies that can help suppress hunger through various pharmacodynamic means. Phentermine, for instance, is a commonly used stimulant for this purpose. Some anti-hyperglycemics indicated for type two diabetes management, like semaglutide are also used off-label for weight loss purposes. Beyond medication, there are, of course, several bariatric surgeries that can be considered, but these are generally used as a last resort depending on the patient. Your PCP will help you decide what interventions beyond a healthy lifestyle may be safe for you to try. If your PCP office does not have some of these more advanced medical services on site, they will likely be able to refer you to a medical weight loss clinic that specializes in treating obesity. 

If you or someone you know is struggling with obesity, I encourage you and/or them to call a primary care doctor. While the internet may be able to provide you with some legitimate weight loss advice, it is littered with information that, in many ways, overcomplicates weight loss, even for us nurses who have excellent health literacy and pride ourselves on being able to understand and communicate health concepts to our friends, families, and patients. At the end of the day, in order to lose weight, you need to maintain a calorie deficit through a combination of eating a healthy diet and getting regular exercise, and the best place to seek out formal advice for what this will look like for you as an individual will be at your PCP office, at least as a starting point.

The health of the public (nurses included) has much to gain by losing some weight, so let's scale back our utilization of the misinformation online and start some meaningful conversations with our healthcare providers, all while setting great examples for our patients so that collectively, our health will benefit!

References/Resources

Health Risks of Overweight & Obesity

COVID-19 pandemic and weight gain in American adults: A nationwide population-based study

Healthy Lifestyle Weight loss - Counting calories: Get back to weight-loss basics

Prescription Medications to Treat Overweight & Obesity

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Tana Bao

About Tana Bao, BSN, MSN, APRN, NP

Tana Bao is a master's prepared family nurse practitioner, dual board certified through both the American Academy of Nurse Practitioners as well as the American Nurses Credentialing Center.

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Specializes in ER.

I would never in a million years go to a standard Health Care provider for nutritional advice. That is a good way to get outdated, misinformation.

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I agree. The most basic is high calorie , high fat foods need to be replc3d with nutritional foods and snacks.  Weight loss will occure when the amount of calories consumed is less than the calories burned. 

Many examples of misinformation about diets and quick fix trends. There is also an emerging trend where some social media influences are claiming that someone who is very overweight is healthy. Where as it may be true to a small extent that very overweight people do not have any immediate presenting health problems, it definitely will cause health problems soon if the weight is not lost. 

From hypertension, diabetes, joint issues and even death. 

Social media has all sorts of misinformation unfortunately.  

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Specializes in Home Health,Peds.

I am morbidly obese. I can’t stand medical providers that suggest low carb and Keto diets. For some reason, I’ve had four doctors trying to get me to go on those diets within the last year. 

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Instead of telling people what they can and can't eat, my long-standing credo is just this:

  • eat when you're hungry
  • stop when full
  • eat foods as close to nature as possible

Surely overly simplistic for some, but it would help a lot of people.

The "clean your plate" rule runs counter to teaching children to pay attention to signals of hunger/fullness. 

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Specializes in Former NP now Internal medicine PGY-3.
On 11/7/2022 at 9:33 AM, mtmkjr said:

Instead of telling people what they can and can't eat, my long-standing credo is just this:

  • eat when you're hungry
  • stop when full
  • eat foods as close to nature as possible

Surely overly simplistic for some, but it would help a lot of people.

The "clean your plate" rule runs counter to teaching children to pay attention to signals of hunger/fullness. 

For real people try to over complicate things. Just look up what a healthy diet is online and eat a net negative calorie balance. Anything more is complicating something simple. It’s more habit and willpower than eating specific things. 
 

aka stop eating little Debbie’s and big max’s and you will lose weight. I can’t even count how many morbidly obese patients say they do not each much, as if the laws of thermodynamics do not apply to them. ?

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Specializes in Intensive Care, Paediatrics, Long-term care.

I love how this article has spawned some good discussion because that is where it all begins. Excellent article.

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On 11/7/2022 at 8:07 AM, Googlenurse said:

I am morbidly obese. I can’t stand medical providers that suggest low carb and Keto diets. For some reason, I’ve had four doctors trying to get me to go on those diets within the last year. 

Why do you think they do this?

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Specializes in Former NP now Internal medicine PGY-3.
1 hour ago, JKL33 said:

Why do you think they do this?

IDK diets diets are fad. Essentially it’s calories in equal calories out. Is it easy? No. I’ve been overweight in the past and it is hard to lose weight. Usually I approach it as keep a diet log first then we will work toward consuming less calories. I feel bad for those who are obese. It is a hard battle with so much good food around. Our environment dictates more of our ability than motivation or self control ever has.

 

-every good book or study on habits ever written. 

 

I think we should send obese people to weight loss camp to lose weight. I would sign up for it myself. 

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On 11/7/2022 at 9:33 AM, mtmkjr said:

The "clean your plate" rule runs counter to teaching children to pay attention to signals of hunger/fullness. 

This might have worked before our plates became the size of semi-truck hubcaps. If people actually looked at the "serving size" on even healthy foods they would be shocked at how small they really are in comparison to what we believe them to be. I read a study once where they took people to their favorite restaurant and had them order their favorite meal but they blindfolded them before they were served. They asked the people to eat until they first felt full and then stop. What happened was rather astonishing. The people in the study only ate an average of 2/3rds of a meal that they normally finished. 

Several things that work for me as I've crossed into the age where weight gain is easy and weight loss nearly impossible is a food diary app ( I use My Fitness Pal), lunch sized plates, my serving of chips/snacks goes in a small plastic bowl (and that's all I get) and finally when I go out to eat I have them bring a box with my meal so I can put half of it away before I even start. 

Of course, with the holidays, that has gone completely out the window. ?

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Specializes in Former NP now Internal medicine PGY-3.

Honestly part of me enjoys the slower metabolism. Cost less in food money to maintain some muscle. Used to have to plow shakes and meat all day to get anything. Not so much now. 

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22 hours ago, Tegridy said:

IDK diets diets are fad.

I asked the question because while I would never endorse keto diet, I do recommend lower carb, rationale being that people aren't overeating broccoli (and if they are its of little caloric consequence)--they're overeating carbs, which is very easy to do.

13 hours ago, Wuzzie said:

If people actually looked at the "serving size" on even healthy foods they would be shocked at how small they really are in comparison to what we believe them to be.

Yes, and it takes a LOT more to burn calories than people think. I was guilty of it until I started keeping better track. We feel so busy (and we are)--we just aren't doing much that really burns calories a lot of the time. I do feel bad for people about this, too. There are numerous different jobs people do that are busy, stressful, degrees of responsibility--stay busy all day, but actually burning a significant amount of calories that would typically be associated with actual exercise?--NO. But then what stinks even more is that many of us are so done at the end of a work day, it takes a significant amount of determination to even think of actual exercise.

People also don't want to hear of a 1200-1400 calorie recommendation for weight loss. Because of the above reasons--they don't feel like they eat much (hear this allllllll day long) and they feel like they are very physically active. But the numbers just aren't going to allow for 2k, 3K+++ calories packed in/24hrs when we are just walking from here to there or sitting at a desk getting up every now and then (or other busy but not truly physically vigorous things people do during their days).

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