Skip to main content
SpringerLink
Log in

Barriers to Treatment

  • Chapter
The Management of Eating Disorders and Obesity

Part of the book series: Nutrition and Health ((NH))

  • 1693 Accesses

Abstract

The treatment of obesity is unlike the medical management of any other disease. It is a chronic, alarmingly common, and incurable disease that is remarkably easy to diagnose with appalling associated disabilities. Nevertheless, for almost all overweight people, the traditional medical care system is irrelevant for the management of their problem (1); and its treatment, therefore, has traditionally followed a format outside the typical care patterns of other chronic diseases.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 189.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 249.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Thomas PR, ed. Weighing the Options: Criteria for Evaluating Weight Management Programs. Prepared by the Committee to Develop Criteria for Evaluating the Outcomes of Approaches to Prevention and Treatment of Obesity. Food and Nutrition Board, Institute of Medicine, Washington, DC: National Academy Press, 1995.

    Google Scholar 

  2. US Dept of Health and Human Services. The Practical Guide: Identification, Evaluation and Treatment of Overweight and Obesity in Adults. NIH Publication No. 00-4084. October, 2000.

    Google Scholar 

  3. National Research Council. Diet and Health: Implications for Reducing Chronic Disease Risk. Prepared by the Committee on Diet and Health, Food and Nutrition Board and Committee on Life Sciences, Washington, DC: National Academy Press, 1989.

    Google Scholar 

  4. Horn J, Anderson K. Who in America is trying to lose weight? Ann Int Med 1993; 119:672–676.

    Google Scholar 

  5. Williamson DF, Serdula MK, Andra RF, Levy A, Byers T. Weight loss attempts in adults: goals, duration and rate of weight loss. Am J Public Health 1992; 82:1251–1257.

    CAS  Google Scholar 

  6. Levy AS, Heaton AW. Weight control practices of US adults trying to lose weight. Ann Int Med 1993; 119:661–666.

    CAS  Google Scholar 

  7. Heaton AW, Levy AS. Information sources of US adults trying to lose weight. J Nutr Educ 1995; 27: 182–190.

    Google Scholar 

  8. Pi-Sunyer FX. Medical hazards of obesity. Ann Int Med 1993; 119:655–660.

    CAS  Google Scholar 

  9. Frank A. A multidisciplinary approach to weight management: the physician’s role and team care alternatives. J Am Diet Assoc 1998; 98: S44–S48.

    Article  CAS  Google Scholar 

  10. Cerulli J, Shafer A. ASHP therapeutic position statement on the safe use of pharmacotherapy for obesity management in adults. Am J Health-Syst Pharm 2001; 58:1645–1655.

    Google Scholar 

  11. Weintraub, M. Long term weight control: The National Heart, Lung and Blood Institute funded multimodal intervention study. Clin Pharm Ther 1992; 51:581–646.

    Article  CAS  Google Scholar 

  12. McNeil BJ. Shattuck lecture—hidden barriers to improvement in the quality of care. N Engl J Med 2001;345:1612–1619.

    Article  CAS  Google Scholar 

  13. Sarlio-Lahteenkorva S, Stunkard A, Rissanen A. Psychological factors and quality of life in obesity. Int J Obes 1995; 19:s1–s5.

    Google Scholar 

  14. Kral JG, Sjostrom LV, Sullivan MB. Assessment of quality of life before and after surgery for severe obesity. Am J Clin Nutr 1992; 55:611S–614S.

    CAS  Google Scholar 

  15. Kaminsky J, Gadaleta D. A study of discrimination within the medical community as viewed by obese patients. Obes Surg 2002; 12:14–18.

    Article  Google Scholar 

  16. Harvey EL, Summerbell CD, Kirk SFL, Hill AJ. Dietitians’ views of overweight and obese people and reported management practices. J Hum Nut Diet 2002; 15:331–347.

    Article  CAS  Google Scholar 

  17. McArthur LH, Ross JK. Attitudes of registered dietitians toward personal overweight and overweight clients. J Am Diet Assoc 1997; 97:63–66.

    Article  CAS  Google Scholar 

  18. Frank A. Futility and avoidance: medical professionals in the treatment of obesity. JAMA 1993; 269: 2132–2133.

    Article  CAS  Google Scholar 

  19. Grizzard T. Undertreatment of obesity. JAMA 2002; 288:2177.

    Article  Google Scholar 

  20. Taras HL, Gage M. Advertising foods on children’s television. Arch Ped Adolesc Med 1995; 149:649–652.

    CAS  Google Scholar 

  21. Coon KA, Tucker KL. Television and children’s consumption patterns. A review of the literature. Minerva Pediatr 2002; 54:423–436.

    CAS  Google Scholar 

  22. Borzekowski DL, Robinson TN. The 30-second effect: an experiment revealing the impact of television commercials on food preferences of preschoolers. J Am Diet Assoc 2001; 101:42–46.

    Article  CAS  Google Scholar 

  23. Domestic advertising spending by category: ranked by measured U.S. expenditures in 2001. AdAge.com. Crain Communications. (Accessed February 18, 2003). Website: (http://www.adage.com/page).

  24. Prentice AM. Overeating: the health risks. Obes Res 2001; 9:234S–238S.

    Google Scholar 

  25. Welch G. Spending in the U.S. on advertising for fast food, sodas and automobiles. Food for thought regarding the type 2 diabetes epidemic. Diabetes Care 2003; 26:546–547.

    Article  Google Scholar 

  26. 100 leading national advertisers: ranked by total U.S. advertising spending in 2001. AdAge.com. Crain Communications. (Accessed February 18, 2003). Website: (http://www.adage.com/page).

  27. Bordo S. Unbearable weight: feminism, western culture and the body. Berkeley, CA: University of California Press, 1993.

    Google Scholar 

  28. Thompson RL, Thomas DE. A cross-sectional survey of the opinions on weight loss treatments of adult obese patients attending a dietetic clinic. Int J Obes 2000; 24:164–170.

    Article  CAS  Google Scholar 

  29. Sobal J. Obesity and socioeconomic status: a framework for examining relationships between physical and social variables. Med Anthropol 1991; 13:231–247.

    Article  CAS  Google Scholar 

  30. Wilson H. Egyptian food and drink. Bucks, UK: Shire Publications Ltd. 1988.

    Google Scholar 

  31. Wadden TA, Stunkard AJ. Social and psychological consequences of obesity. Ann Int Med 1985; 103: 1062–1067.

    CAS  Google Scholar 

  32. Frank A. Accreditation and certification: the rationalization of obesity management services. Am J Clin Nutr 1995; 62:439–440.

    CAS  Google Scholar 

  33. Frank A. It’s time to regulate the diet industry. Med Econ 1993; 70:23–30.

    Google Scholar 

  34. Schachter S. Recidivism and self cure of smoking and obesity. Am Psychologist 1982; 37:436–444.

    Article  CAS  Google Scholar 

  35. Rzewnicki R, Forgays DG. Recidivism and self-cure of smoking and obesity: an attempt to replicate. Am Psychologist 1987; 42:97–100.

    Article  CAS  Google Scholar 

  36. Klem M, Wing R, McGuire M, Seagle H, Hill J. A descriptive study of individuals successful at long term maintenance of substantial weight loss. Am J Clin Nutr 1997; 66:239–246.

    CAS  Google Scholar 

  37. Pinto BM, Maruyama NC, Clark MM, Cruess DG, Park E, Roberts M. Motivation to modify lifestyle risk behaviors in women treated for breast cancer. Mayo Clin Proc 2002; 77:122–129.

    Google Scholar 

  38. Kuczmarski RJ, Fegal KM, Campbell ST, and Johnson CL. Increasing prevalence of overweight among US adults: the National Health and Nutrition Examination Surveys, 1990 to 1996. J Am Med Assoc 1994; 272:205–211.

    Article  CAS  Google Scholar 

  39. Uba L. Cultural barriers to health care for southeast Asian refugees. Pub Health Reports 1992; 107: 544–548.

    CAS  Google Scholar 

  40. Valdez RB, Giachello A, Rodriguez-Trias H, Gomez P, de la Rocha C. Improving access to care in Latino communities. Pub Health Reports 1993; 108:534–539.

    CAS  Google Scholar 

  41. Woloshin S, Bicknell NA, Schwartz LM, Gany F, Welch HG. Language barriers in medicine in the US. JAMA 1995; 273:724–728.

    Article  CAS  Google Scholar 

  42. van der Sande A, Bailey R, Faal H, et al. Nationwide prevalence study of hypertension and related noncommunicable diseases in The Gambia. Trop Med Int Health 1997; 2:1039–1048.

    Article  Google Scholar 

  43. Ashton CM, Haidet P, Paterniti DA, et al. Racial and ethnic barriers in the use of health services. J Gen Int Med 2003; 18:146–152.

    Article  Google Scholar 

  44. Miller LA, Grunwald GK, Johnson SL, Krebs NF. Disease severity at time of referral for pediatric failure to thrive and obesity: time for a paradigm shift? J Pediatr 2002; 141:6–7.

    Article  Google Scholar 

  45. Uzark KC, Becker MH, Dielman TE, Rocchini AP, Katch V. Perceptions held by obese children and their parents: implications for weight control intervention. Health Education Q 1988; 15:185–198.

    CAS  Google Scholar 

  46. Gupta K, Gupta S. Undertreatment of hypertension: a dozen reasons. Arch Int Med 2002; 162: 2246–2247.

    Article  Google Scholar 

  47. Rossi SR, Rossi JS, Rossi-DelPrete LM, Prochaska JO, Banspach SW, Carleton RA. A processes of change model for weight control for participants in community-based weight loss programs. Int J Addict 1994; 29: 161–177.

    CAS  Google Scholar 

  48. Kushner RF. Barriers to providing nutrition counseling by physicians: a survey of primary care practitioners. Prev Med 1995; 24:546–552.

    Article  CAS  Google Scholar 

  49. Bowerman S, Bellman M, Saltsman P, et al. Implementation of a primary care physician network obesity management program. Obes Res 2001; 9:321s–325s.

    Article  Google Scholar 

  50. Oliveria SA, Lapuerta P, McCarthy BD, L’Italien GJ, Berlowitz DR, Asch SM. Physician-related barriers to the effective management of hypertension. Arch Int Med 2002; 162:413–420.

    Article  Google Scholar 

  51. Story MT, Neumark-Stzainer DR, Sherwood NE, et al. Management of child and adolescent obesity: attitudes, barrier skills, and training needs among health care professionals. Pediatr 2002; 110:210–214.

    Google Scholar 

  52. Ling BS, Moskowitz MA, Wachs D, Pearson B, Schroy PC. Attitudes toward colorectal cancer screening tests. J Gen Intern Med 2001; 16:822–830.

    Article  CAS  Google Scholar 

  53. American Obesity Association. Physical activity for adult weight control. Healthy Weight 2010. Objective #2.7. Washington, DC: American Obesity Association (AOA), January 20, 2000.

    Google Scholar 

  54. Ball K, Crawford D, Owen N. Too fat to exercise? Obesity as a barrier to physical activity. Aust N Z J Public Health 2000; 24:331–333.

    CAS  Google Scholar 

  55. Chakravarthy MV, Joyner MJ, Booth FW. An obligation for primary care physicians to prescribe physical activity to sedentary patients to reduce the risk of chronic health conditions. Mayo Clin Proc 2002; 77:165–173.

    Google Scholar 

  56. American Obesity Association. A pound of prevention for a healthier tomorrow. American Obesity Association (AOA) Report 1999; 3.

    Google Scholar 

  57. Foster GD, Wadden TA, Phelan S, Sarwer DB, Sanderson RS. Obese patients’ perceptions of treatment outcomes and the factors that influence them. Arch Intern Med 2001; 161:2133–2139.

    Article  CAS  Google Scholar 

  58. Kottke TE, Wu LA, Hoffman RS. Economic and psychological implications of the obesity epidemic. Mayo Clin Proc 2003; 78:92–94.

    Google Scholar 

  59. Franklin PA. Impact of disability on the family structure. Soc Secur Bull 1977; 40:3–18.

    CAS  Google Scholar 

  60. Black DR. Weight changes in a couples program: negative association of marital adjustment. J Behav Ther Exp Psychiatr 1988; 19:103–111.

    Article  CAS  Google Scholar 

  61. Wynick, M. Nutrition education in medical schools. Am J Clin Nut 1993; 58:825–827.

    Google Scholar 

  62. Davis CH. The report to Congress on the appropriate federal role in assuring access by medical students, residents and practicing physicians to adequate training in nutrition. Pub Health Reports 1994; 109:824–826.

    CAS  Google Scholar 

  63. Weinsier RL, Boker JR, Brooks CM, et al. Priorities for nutrition content in medical school curriculum; a national consensus of medical educators. Am J Clin Nutr 1989; 50:707–712.

    CAS  Google Scholar 

  64. Hill JO. Dealing with obesity as a chronic disease. Obes Res 1998; 6:34s–38s.

    Google Scholar 

  65. Galuska DA, Will JC, Serdula MK, Ford ES. Are health care professionals advising obese patients to lose weight? J A M A 1999; 282:1581–1582.

    Article  Google Scholar 

  66. Kushner R. The treatment of obesity: a call for prudence and professionalism. Arch Int Med 1997; 157:602–604.

    Article  CAS  Google Scholar 

  67. Rossner S. Long-term intervention strategies in obesity treatment. Int J Obes 1995; 19:s29–s33.

    Google Scholar 

  68. Sayler ME, Goldstein DJ, Roback PJ, Atkinson RL. Int J Obes 1994; 18:742–751.

    CAS  Google Scholar 

  69. Atkinson RL. Proposed standards for judging the success of the treatment of obesity. Ann Int Med 1993; 119:677–680.

    CAS  Google Scholar 

  70. Frank A. Measuring maintenance: an index for measuring and comparing the maintenance of weight loss. Obes Res 1996; 4:54s.

    Google Scholar 

  71. Shekelle PG, Hardy ML, Morton SC, et al. Efficacy and safety of ephedra and ephedrine for weight loss and athletic performance: a meta-analysis. JAMA 2003; 289:1537–1545.

    Article  CAS  Google Scholar 

  72. Fontanarosa PB, Rennie D, DeAngelis CD. The need for regulation of dietary supplements—lessons from ephedra. J A M A 2003; 289:1568–1570.

    Google Scholar 

  73. Bray GA. Drug treatment of obesity. Amer J Clin Nutr 1992; 550:538s–544s.

    Google Scholar 

  74. National Task Force on the Prevention and Treatment of Obesity. Towards prevention of obesity: research directions. Obes Res 1994; 2:571–584.

    Google Scholar 

  75. Klem ML, Viteri JE, Wing RR. Primary prevention of weight gain for women aged 25–34: the acceptability of treatment formats. Int J Obes 2000; 24:219–225.

    Article  CAS  Google Scholar 

  76. Jeffery RW, Hellerstedt WL, Schmid TL. Correspondence programs for smoking cessation and weight control: a comparison of two strategies in the Minnesota Heart Health Program. Health Psychol 1990; 9:585–598.

    Article  CAS  Google Scholar 

  77. Clothier N, Marvel MK, Cruickshank CS. Does presenting patients’ BMI increase documentation of obesity? Med Educ Online 2002; 7:6. (Accessed Spetember 5, 2002.) Website: (http://www.meded-online.org).

    Google Scholar 

  78. Hash RB, Munna RK, Vogel RL, Bason JJ. Does physician weight affect perception of health advice? Prev Med 2003; 36:41–44.

    Article  Google Scholar 

  79. Frank A. Conflicts in the care of overweight patients: inconsistent rules and insufficient money. Obes Res 1997; 5:268–270.

    CAS  Google Scholar 

  80. Hearn W. Healthy Eats. American Medical News, November 20, 1995, p. 25.

    Google Scholar 

  81. Tershakovec AM, Watson MH, Wenner MJ, Marx AL. Insurance reimbursement for the treatment of obesity in children. J Pediatr 1999; 134:573–578.

    Article  CAS  Google Scholar 

  82. Campbell GR. A weighty problem: a new drug therapy stirs debate about how health plans ought to contain obesity’s crushing costs. Managed Health Care 1996 (July);s11–s19.

    Google Scholar 

  83. Quesenberry CP, Caan B, Jacobson A. Obesity, health services use, and health care costs among members of a health maintenance organization. Arch Int Med 1998; 158:466–472.

    Article  Google Scholar 

  84. Collins RW, Anderson JW. Medication cost savings associated with weight loss for obese non-insulin dependent diabetic men and women. Preventive Med 1995; 24:369–374.

    Article  CAS  Google Scholar 

  85. Bray GA. Barriers to the treatment of obesity (editorial). Ann Int Med 1991; 115:152–3.

    CAS  Google Scholar 

  86. Krentzman B. State Laws on Obesity Medications. (Accessed March 17, 2003.) Website: (http://home.attbi.com/~bkrentzman/obesity/state.laws.html.)

  87. American Obesity Association. AOA Fact Sheets: Obesity and Health Insurance. (Accessed March 12, 2003.) Website: (http://www.obesity.org/subs/fastfacts//Obesity)

  88. American Obesity Association. AOA Fact Sheets: Obesity, Medicaid and Medicare. (Accessed March 12, 2003.) Website: (http://www.obesity.org/subs/fastfacts//Obesity).

  89. American Obesity Association. AOA Fact Sheets: Obesity Research. (Accessed March 12, 2003.) Website: (http://www.obesity.org/subs/fastfacts//Obesity).

  90. Ad Council to launch anti-obesity PSAs. AdAge.com.Crain Communications. (Accessed February 18, 2003.) Website: (http://www.adage.com/page>).

  91. Wyden R. Deception and Fraud in the Diet Industry. Hearings before the Subcommittee on Regulation, Business Opportunity and Energy of the Committee on Small Business of the US House of Representatives. Serial Number 101–57, May 7, 1992.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. The George Washington University Weight Management Program, Washington, DC

    Arthur Frank MD

Authors
  1. Arthur Frank MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Pharmacology and Toxicology, Indiana University School of Medicine and PRN Consulting, Indianapolis, IN

    David J. Goldstein MD, PhD

Rights and permissions

Reprints and permissions

Copyright information

© 2005 Humana Press Inc.,Totowa,NJ

About this chapter

Cite this chapter

Frank, A. (2005). Barriers to Treatment. In: Goldstein, D.J. (eds) The Management of Eating Disorders and Obesity. Nutrition and Health. Humana Press. https://doi.org/10.1385/1-59259-865-X:375

Download citation

  • DOI: https://doi.org/10.1385/1-59259-865-X:375

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-341-1

  • Online ISBN: 978-1-59259-865-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation