Locus of control (LOC) remains as a much unexplored territory in the healthcare industry. Even most individuals are unfamiliar with the term which becomes crystal clear and relatable once it is defined. The concept was designed in 1954 and is an individual’s belief system regarding his/her experiences and the factors associated with success or failure. It is the tendency of people to believe that control resides internally within them or externally with others/situation.
LOC can be internal or external depending on the person involved. People with an internal LOC attribute success or failure to themselves and believe that events in their life occur primarily from their own actions. Individuals with an external LOC attribute success to luck or fate. For example, when a project result is announced, people with an internal LOC praise or blame themselves for the result whereas those with an external LOC blame/praise factors such as timeframe and other team members for success or failure of the project.
Health locus of control (HLOC) attributes people’s opinion about who or what is responsible for management of their health conditions. LOC affects a person’s attitude towards health and can influence outcomes too. When adults believe that their health is in their hands, it results in decreased use of emergency departments, reduced number of diseases, adherence to healthy habits, following treatment procedures and sticking to general health goals. People with an external LOC believe that their health is in the hands of doctors, nurses and fate and mostly do nothing to keep their health in check which affects quality of life.
There are numerous studies that discuss about physician- patient relationship which commonly discusses about satisfaction with one’s physician, a modus operandi between the patient and the physician regarding the medical problem at hand and above all, trust and belief in the physician. Whereas, the health locus of control which deals extensively about the way in which an individual attributes his/her health to his/her own actions or environmental circumstances and other external factors is an area that remains much unexplored compared to the physician-patient relationship.
One major characteristic of a physician-patient relationship is trust and this measure depends on various attributes. Patients with HIV had significantly higher trust in their physician and also those who have a family background of trusting and accepting doctors are likelier to exhibit the same characteristics. Also, individuals suffering from multiple chronic diseases are constantly in touch with their physician and ultimately, develop higher levels of trust with them.
HLOC’s Role in Obesity
Locus of control occupies prime importance in the field of obesity because as per definition, it indicates whether an individual believes that his/her choices and the external environment are under his or her control or not. That’s because, along with hunger and satiety cues an individual’s ability to understand these cues will be greatly appreciated and help in determining how obesity starts developing and proceeds.
When an individual solely relies/complains on external factors affecting obesity, there are two ways to look into this. Generally, an external LOC is related to depression and anxiety which makes these individuals give up on an issue rather than sticking to perseverance and completing it. Such people have higher levels of cortisol which can affect long-term health. Cortisol might trigger the individual to eat more due to stress and become obese. Another dimension is that, externally focused people might benefit from help provided by dietitians, nutritionists and healthcare providers. All said and done, internally focused individuals reap more benefits and tend to succeed in their endeavor to lose weight compared to their externally focused counterparts. This is true! When an individual is determined from his/her end to take up weight loss as a priority task and work on it whatever effort and commitments it might take, he/she is sure to succeed, at least to a greater extent. But, when an individual relies solely on external factors, the person might follow the diet prescribed and exercise for some time but ultimately give up on his/her goals and blame the dietitian, physician, workload, family commitments or lack of time for his/her ultimate failure. Dietitians at www.firsteatright.com can be of utmost help in enabling an obese/overweight person to lose weight in the right way with constant encouragement, support and the right kind of diet chart and exercise plan.
Besides healthcare providers and physicians, family, friends and peers form the major chunk of population who are responsible for the relationship between locus of control and obesity. These people play a vital role in the externally focused group by encouraging the individual, motivating him/her, discouraging sedentary behavior and making it less available (parents can do this at home).
HLOC & Diabetes Control
HLOC is also used in the field of diabetes to assess a patient’s response using different studies. Researchers have concluded with these studies that a person enforces more control over his/her health when the locus of control is internal rather than being external. This greater control leads to improved personal health and those individuals diagnosed with diabetes are likelier to stick strictly to their health regimen when they experience an increase in internal locus of control. A study of 115 patients with type 2 diabetes proved that perceived control was negatively related to HbA1c levels. A high-perceived control had a beneficial effect on individuals with type 2 diabetes. When physicians encourage patients to follow dietary regulations and exercise regularly, appreciate their success by giving positive feedbacks and help them feel in control of their illness by motivating them, it might enhance internal locus of control and be used for effective intervention.
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Dietitian & Nutritionist Dr. Nafeesa Imteyaz.