+44 (0)191 640 3638
enquiries@onyxhealth.com
Generator Studios
Trafalgar Street
Newcastle-upon-Tyne
NE1 2LA
 |
By Sarah Seilly, Head of Medical Education at Onyx Health
|
|---|
Onyx Health’s Head of Medical Education, Sarah Seilly, discusses why our response to health crises requires a new approach – one that places empathy at its centre.
Despite more awareness surrounding the issue now than ever before, obesity continues to pose a significant challenge to England’s health and economy, affecting millions of lives and costing the NHS around £6.5 billion per year.1 Today, 26% of adults and 23.4% of children in England are living with obesity – figures that have been increasing for decades, and that are expected to escalate if action is not taken.1,2
Recent years have seen many public health initiatives aimed at tackling the rising threat of obesity across England and the rest of the UK, and much attention was placed on the issue in the run-up to this year’s general election.3,4 Statistics on the dangers surrounding obesity surround us, yet the upward trend continues. So, why isn’t the situation improving?
The fact is, if we want to genuinely support those living with obesity and create a healthier future for the country, the solution hinges on truly listening to the voices of patients on the frontline to identify the root causes and impacts, while equipping healthcare professionals (HCPs) with the necessary tools to offer meaningful support.
While obesity results from an imbalance of energy involving dietary intake and physical activity, solving the issue isn’t as simple as ‘eating less and moving more’.5 We need to look instead to the behavioural patterns and environmental causes that result in obesity to improve our understanding.
Obesity is a multifactorial issue, influenced by diverse factors ranging from structural issues like agriculture, food services, education and urban planning, to challenges facing individuals such as limited time, alcohol consumption and the ready availability of convenience foods. The roles of genetics, socio-economic status and cultural influences further complicate the picture. 6 Addressing these issues requires change at programme, policy and societal levels, but the complexity of obesity is often reduced to individual blame. This oversimplification undermines effective support.
Enter weight stigma. Despite the many factors which can contribute to an individual living with obesity, many associate overweight or obesity with personal failure – and the healthcare system can also be susceptible.7,8
While the bariatric and weight management teams that work directly with people with obesity understand the condition well and are working hard to make a difference, and HCPs generally strive to understand and empathise with patients, there is work to be done.
Studies show that some HCPs hold negative or stereotyped perceptions of people living with obesity which, while often implicit, can influence their judgement, face-to-face interactions and decision-making in the care they provide.9 In turn, experiences or expectations of poor treatment may cause stress, avoidance of care, poor adherence to treatment and mistrust of HCPs among patients living with obesity.9
Bringing better care to people living with the condition starts with providing the tools for breaking down this stigma.
Changing our approach to educating HCPs on obesity and other complex public health issues holds much potential for improving the nation’s health.
Until now, traditional methods in Continuous Professional Development (CPD) have had limited success in the area of obesity, tending towards single activities and passive approaches such as lectures.10 But targeted, ongoing HCP education that promotes empathy delivers encouraging results and has been found to improve patient outcomes.10
A 2020 interventional study on obesity that engaged HCPs in competence building using real-life situations reported improvements in physicians’ general attitude towards patients, while patients’ self-efficacy for obesity management and readiness to change lifestyle was increased. This approach was found to show improvements in weight and waist measurement 12 months after the interventions.10
Results like these show that empathy is an indispensable tool for tackling obesity and similar misunderstood health conditions, yet recent research suggests the “hidden curriculum” in healthcare education erodes empathy rather than boosting it. Unfortunately, the demanding workloads of HCPs, organisational culture in healthcare and poor role models have been found to breed cynicism and emotional detachment among healthcare students.11
This should give us cause for concern. Throughout my career, I’ve been lucky enough to witness the transformative power of empathy and how it can change healthcare delivery and enhance patient wellbeing. Techniques can be really simple, such as sharing patient experiences among HCP colleagues, or more in depth, like simulations that replicate the patient experience. Both are effective and have a crucial role to play in increasing understanding of patients, but this does not happen in isolation.
When dealing with conditions like obesity where the care landscape is fractured, collaboration is more important than ever. GPs are generally patients’ main point of contact, but there is strength in connecting the disparate parties that serve patients. At Onyx Health, we work to connect clinical teams to the patient organisations, life science companies and key opinion leaders relevant to their practice. Our work has transformed attitudes and practices by uncovering the hidden truths within the therapy areas our partners operate in, ensuring better patient outcomes through shared insights and understanding.
That’s why it’s so troubling to hear that one in six integrated care boards (ICBs) in England has stopped accepting new patients for specialist weight management services.12 These services unite multidisciplinary teams including physicians, physiotherapists, dietitians, and mental health specialists to support patients in tackling obesity, but demand currently far exceeds capacity and it is as yet unclear where provision will come from.
Confronting obesity effectively will involve a transition from traditional, insular approaches to the problem to a comprehensive, empathetic and collaborative model of care. Complex conditions require more than awareness campaigns aimed at the public and one-off training sessions for practitioners that are lost among the competing demands of caring for patients. We need a fundamental shift in how HCPs are educated and how care is delivered.
By dismantling stigma, deepening understanding and connecting various stakeholders, we can equip HCPs with more nuanced understanding so that they in turn can provide effective support. By placing these principles at the heart of medical education strategies, we can hope for a healthier future for individuals and society as a whole.