Despite the effectiveness of diet therapy and increased physical activity to reduce body weight, proven by numerous studies, the question of motivation and the level of compliance with recommendations for the implementation of the developed rehabilitation programs remains open. Therefore, the problem of increasing rehabilitation compliance in obese patients is urgent. The purpose of the study was the analysis of the causes of low rehabilitation compliance and the search for ways to improve it in patients with alimentary–constitutional obesity in the context of defining short and long–term rehabilitation goals. Material and methods. Interviews were conducted with 288 people of the second mature age with nutritional–exogenous obesity of the I–III degree, diagnosed by body mass index. Participants were responsible for asking a questionnaire to determine the causes of low compliance and possible ways to correct it. After one–year rehabilitation period, a retrospective determination of effective methods to increase the level of rehabilitation compliance was carried out. Results and discussion. The most common causes of low compliance were: the difficulty of remembering programs; lack of sharp pain; hunger and fatigue; the difficulty of adapting previous attempts to lose weight to thier usual lifestyle; inefficiency of previous attempts to lose weight. Less common were the lack of support from the family and the others; spending a lot of time on programs; additional financial burden; distrust of non–drug methods of treatment. When identifying possible methods for improving the level of rehabilitation compliance, patients indicated the need for additional information on the course, complications and risks of obesity, principles and mechanisms of the impact of rehabilitation measures; individual approach to specific conditions of life, work, financial status. Patients needed psychological support from a therapist and from family members and those around them, they could implement recommendations to improve their own condition and, thus, solve their problems (aesthetic, personal, career, related to health). When determining the possible duration of body weight correction, most patients considered the annual period of time to achieve the target or desired weight to be optimal. Representatives of all groups had an understanding of lifelong lifestyle control, most often with the morbid form of obesity. In a retrospective analysis of measures to increase compliance, the most effective were frequent personal and constant mobile monitoring by a physical therapist; aesthetic improvement; improvement of well–being; an individual approach to drawing up a rehabilitation program, taking into account personal and financial factors. Self–monitoring diaries, psycho–emotional support, improving personal and family relationships turned out to be less effective. Conclusion. We conducted detailed inquiries in order to find out the reasons for low compliance and methods for improving that allowed us to identify the individual motivation of patients, to determine the short and long–term rehabilitation goals.
Keywords: obesity, compliance, physical therapy, rehabilitation
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