“Motivational Interviewing for Adolescent Obesity” (Viewpoint, January) addresses an issue of great urgency, and one that's very close to my heart as a health care provider and as someone who has struggled with her weight.
This has been a lifelong problem for me, but I had the most difficulty managing my weight during adolescence. I practiced habits that were unhealthy on both ends of the spectrum, from anorexia to overeating and inactivity, which led to obesity. I have since lost the weight in a healthy way, but I strongly believe I could have achieved this goal much earlier had my providers implemented an approach that included motivational interviewing, which addresses not only the difficulty of losing weight but also the important role the adolescent's family plays in mediating this outcome.
The standard nursing approach—assessment, diagnosis, planning, implementation, and evaluation—does very little to integrate family members and the patient into the plan of care, and it can be patronizing. It's incredibly hard for overweight teens to become inspired to make healthy changes when a nurse is instructing them about all the things they're doing wrong, placing blame, disregarding the unique needs of each patient, and utilizing standardized instructions to convey what the child should do to lose weight.
Most people with obesity know what they should do. What they need is someone who can offer them empathy, acknowledging that weight loss is a difficult task, helping them figure out how to do it, and providing motivation and support.
Perhaps if more providers used the motivational interviewing approach, we might not only begin to decrease obesity in our youngest populations but also prevent its development. As a nursing student and novice practitioner, I intend to implement these ideas in my practice.
Alicia M. Sousa, CNA
For more letters from AJN readers, go to http://links.lww.com/AJN/A47.