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Obesity, knee osteoarthritis, and polypathology: factors favoring weight loss in older people

机译：肥胖，膝关节骨关节炎和多病理学：有利于老年人减肥的因素

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Aim: We aimed to explore the meaning of obesity in elderly persons with knee osteoarthritis (KO) and to determine the factors that encourage or discourage weight loss. Background: Various studies have demonstrated that body mass index is related to KO and that weight loss improves symptoms and functional capacity. However, dietary habits are difficult to modify and most education programs are ineffective. Design: A phenomenological qualitative study was conducted. Intentional sampling was performed in ten older persons with KO who had lost weight and improved their health-related quality of life after participating in a health education program. A thematic content analysis was conducted following the stages proposed by Miles and Huberman. Findings: Participants understood obesity as a risk factor for health problems and stigma. They believed that the cause of obesity was multifactorial and criticized health professionals for labeling them as “obese” and for assigning a moral value to slimness and diet. The factors identified as contributing to the effectiveness of the program were a tolerant attitude among health professionals, group education that encouraged motivation, quantitative dietary recommendations, and a meaningful learning model based on social learning theories. Conclusion: Dietary self-management without prohibitions helped participants to make changes in the quantity and timing of some food intake and to lose weight without sacrificing some foods that were deeply rooted in their culture and preferences. Dietary education programs should focus on health-related quality of life and include scientific knowledge but should also consider affective factors and the problems perceived as priorities by patients.
机译：目的：我们旨在探讨肥胖症在老年人膝骨关节炎（KO）中的意义，并确定促进或阻止体重减轻的因素。背景：各种研究表明，体重指数与KO有关，减肥可以改善症状和功能。但是，饮食习惯很难改变，大多数教育计划都没有效果。设计：进行了现象学定性研究。在参加健康教育计划后，对十名体重减轻并改善了与健康相关的生活质量的KO老年人进行了有意采样。按照Miles和Huberman提出的阶段进行了主题内容分析。调查结果：参与者将肥胖理解为健康问题和耻辱的危险因素。他们认为肥胖的原因是多方面的，并批评卫生专业人员称其为“肥胖”，并为减肥和饮食赋予道德价值。有助于该计划有效性的因素包括卫生专业人员的宽容态度，鼓励动机的团体教育，定量饮食建议以及基于社会学习理论的有意义的学习模型。结论：饮食自我管理无限制，可以帮助参与者改变一些食物的摄入量和时间，并在不牺牲根植于他们的文化和偏好的某些食物的前提下减肥。饮食教育计划应着重于健康相关的生活质量，并包括科学知识，但也应考虑情感因素和患者认为是优先事项的问题。

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