Addressing psychological factors impacting a patient's ability to maintain a healthy weight involves a holistic, sensitive, and individualized approach. Begin by discussing with the patient any psychological or emotional barriers, including stress, emotional eating, or weight stigma, that may affect their motivation and ability to make sustainable lifestyle changes NICE NG246. Recognize and validate any concerns or negative experiences related to weight management interventions, and explore how social and cultural contexts influence their perceptions and behaviours around food and activity NICE NG246. Encourage patients to identify specific behaviours or situations that undermine their efforts, such as using food for emotional comfort or difficulties maintaining routines during social events or holidays, and collaboratively develop strategies to manage these triggers NICE NG246.
Support patients in adopting gradual, achievable changes rather than extreme or unsustainable behaviours, which can negatively impact mental health and adherence NICE NG246. Promote self-monitoring behaviours like regular, but not obsessive, weighing, tracking physical activity, and noting food intake, while being cautious to avoid triggering disordered eating patterns NICE NG246. Provide access to accurate, non-stigmatizing information and local support services that address both psychological and physical aspects of weight management NICE NG246.
It is also crucial to address weight stigma explicitly, as it is a significant psychosocial contributor to obesity that can impair self-esteem, increase stress, and reduce engagement with health services Puhl et al. 2020. Creating a supportive, non-judgmental environment helps reduce internalized stigma and encourages sustained behaviour change Puhl et al. 2020. Tailoring interventions to individual psychological needs, including referral to mental health support when appropriate, enhances effectiveness NICE NG246.
Overall, integrating psychological support with dietary and physical activity advice, acknowledging cultural and social factors, and addressing stigma can improve patients’ ability to maintain a healthy weight sustainably NICE NG246; Puhl et al. 2020.