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Rebecca Oakes

6/6/16
HEA 676
Final Paper
Health Coaching Individuals Who Are Overweight/Obese

Obesity is a growing epidemic within the United States. Because of the steady rise in the
number of obese individuals, it is important that there are areas in which these individuals
receive help. Interestingly, individuals who are reported overweight or obese who also have a
reported serious mental illness are more than twice the rate of individuals without a reported
serious mental illness (Aschbrenner, et al.). Obesity attenuates many other chronic health
conditions such as cardiovascular disease (CVD), diabetes, pulmonary diseases and many others.
Unfortunately, it is not uncommon for individuals to place the blame of an individual's obesity
status upon that individual. As a result, many of these overweight or obese individuals may not
be given care that is appropriate to their condition. Many times diet and exercise advice are
dumped into their lap without any regard to the thoughts and concerns of the individual. This is
where health coaching becomes beneficial. A health coach is there for the sole purpose of
working with the individual to achieve their health goals. Instead of dumping a pile of
information in their laps or "shoulding" them so-to-speak, health coaches act as an ally that is an
open resource to use for the benefit of the individual who they are working with. By looking into
the literature, it is important to take into consideration that health coaching, in fact, was proven
to be effective when addresses the overweight and obese population. The purpose of this paper is
to delve further into the literature discussing the effectiveness on various health coaching
methods and its impact on the overweight and obese population.
The first two articles that I wish to discuss also incorporate the issue of overweight or
obese individuals and the added diagnosis of a serious mental illness. As the burden of obesity
grows in this population, innovative, cost-effective, and scalable interventions are needed that
require less intensive resources while delivering effective behavior change strategies for at-risk
individuals with SMI (Aschbrenner, et al.). One of these innovative, cost effective, and scalable
interventions would be to have these individuals work with a health coach. Aschbrenner et al.,
and Bartels et al., discuss health coaching's effectiveness within this population. Participants
within the Bartels et al., trial (210), were more successful losing weight with a coach rather than
being left to their own devices. These findings were found to be sustained at an eighteen month
follow-up period. Additionally, Aschbrenner et al., used peer health coaching as their particular
form of health coaching. According to Aschbrenner et al., peer support is a proven strategy for
motivating and sustaining behavior change in general health care populations. In order to further
support this foregone conclusion, Aschbrenner et al., cultivated a study population of ten
individuals with a reported serious mental issue and classified as overweight or obese to
determine if peer health coaching is effective. Upon conclusion of the study, it was found that
there was a high satisfaction rate after they completed the study and there was a small decline in
weight by 56% of the individuals within the study. However, the mean weight of participants did
not change by a significant proportion. Unfortunately because this study did not produce
adequate study participants it is difficult to determine the effectiveness of the results.

The remaining three articles each look into overweight and obese individuals separately
from the diagnosis of a serious mental illness. The first of the three was performed by Merrill et
al., and it determined that interactive health coaching was a method of coaching that significantly
lowered an individuals body mass index (BMI) through a three, six, and one year of follow-up.
Gottschalk et al., analyzed the younger population of obese individuals by determining the
effectiveness of health coaching when addressing obesity levels. They were able to conclude
that, coaching is an acceptable strategy to address pediatric obesity and can successfully engage
adolescnets (Gottschalk et al.). Finally, Leahel et al., wanted to understand the impact that
professional, peer, and mentor health coaching has on obesity treatment. Results suggest that
health coaches for obesity treatment are feasible and that incorporating coaches into a reduced
intensity treatment may yield weight losses comparable to more intensive programs that involve
weekly group sessions (Leahel et al.). While these results yielded favorable outcomes, it was
projected that an added benefit may further the effectiveness of health coaching on obese
individuals.

So, after looking at the literature, each article suggested that health coaching is, indeed,
effective when working with obese individuals. This effectiveness was found in adults as well as
the adolescent population. One thing that has not been done, however, is a randomized control
trial lasting over a longer period of time that would help to determine the effects health coaching
would have over a significant amount of time. Because health coaches stay within the scope of
the code of ethics, one may call into question the ethical concerns of placing an individual within
a randomized control trial within a non-treatment group. While each article's findings contributed
to the overall content of this paper, I found a lacking of the coaching spirit within these
respective articles. I believe that by further describing the nature of the spirit within each article
would help to understand a little more the nature of the health coaching taking place. What I take
away from these articles is that health coaches definitely help the obese and overweight
population. By giving these individuals an alternative approach to treatment there was an
obvious improvement of their health status. In addition, if I were to make a case for health
coaching to a supervisor I would need more, consistent information regarding the individuals
satisfaction with the health coaching method. While results are always something that
researchers look at, sometimes it is important to take a step back and to gauge the satisfaction
that an individual has with a specific treatment method. Satisfaction is also important in regards
to adherence. If individuals are to adhere to health coaching as a form of treatment, it would be
beneficial if they were also satisfied with this form of treatment.
Table of Contents

Aschbrenner, K., Naslund, J., Barre, L., Mueser, K., Kinney, A., Bartels, S. (2015). Peer health
coaching for overweight and obese individuals with serious mental illness: intervention
development and initial feasibility study. Translational Behavioral Medicine, (5)3:277-
284.

Bartels, S., Pratt., S., Aschbrenner, K., Barre, L., Naslund, J., Wolfe, R., Xie, H., McHugo, G.,
Jimenez, D., Jue, K. (2015). Pragmatic replication trial of health promotion coaching for
obesity in serious mental illness and maintenance of outcomes. American Psychiatric
Assn, (172)4: 344-352.

Gottschalk, L., Stevens, D., Jensen, A., Beyrouty, M., Skursky, N., Murphy, J., Schwartz, M.,
Sherman, S. (2014). The fit kid & fit teen coaching program: addressing obesity with the
added support of health coaches. Journal of Adolescent Health, (56)2:104-105

Leahey, T. M., Wing, R.R. (2013). A randomized controlled pilot study testing three types of
health coaches for obesity treatment: professional, peer, and mentor. Obesity Journal,
(21)5: 928-934.

Merrill, R., Aldana, S., Bowden, D. (2010). Employee weight management through health
coaching. Eating and Weight Disorders, (15)1-2:52-59.