With the latest health data estimating that about 70% of adults are overweight or have obesity, it’s crucial for all healthcare professionals to understand the nuances of providing care to patients with obesity and other weight-related comorbidities. These conditions can impact nearly every organ in the body and put patients at a higher risk for developing life-threatening health conditions like diabetes, heart disease, cancer, and mental health issues.
As healthcare professionals, we have an obligation to ensure our patients receive the best care possible. This includes having tough conversations with patients about things like their weight, diet, and levels of activity. It is part of our job, and being prepared for these types of discussions will go a long way in helping patients overcome challenges with weight and improve their overall health.
When to Talk to About Weight
It’s important to have an open dialogue with all patients, but especially with those who are displaying medical indicators of being overweight or having obesity. If a patient shows signs of unhealthy weight gain, has an elevated BMI, takes certain medications that can contribute to weight gain, or has a family history of obesity, it may be time to have a respectful and nonjudgmental conversation about their weight.
Approach the discussion with compassion and never assume weight-related issues are at the top of a patient’s list of health concerns. Ask patients about their overall health and inquire about their physical and emotional well-being. Let patients lead the discussion, and when the moment is right, ask them if they would like to discuss their weight and the health risks associated with being overweight. If they do, wonderful. If they don’t, respect their wishes and explain that you are always available to answer any questions.
How to Have Tough Conversations
Research shows that having an inclusive conversation void of judgment with preferred terms—such as “overweight” and “healthy nutrition plans”—can improve physician–patient relations and help patients receive better care. Open-ended questions like “How do you feel about your weight?” are also encouraged to help guide the conversation and tap into each patient’s mindset and needs.
Other topics to potentially discuss include:
- Eating and Drinking Patterns: Ask about daily eating habits and nutritional intake. Find out what “healthy eating” means to your patient and advise them based on their answers. I educate my patients on healthy foods, foods to avoid, and mindful, intuitive eating.
- Physical Activity: Start by talking about the benefits of physical activity and explain that a little movement can have a major impact on physical and mental health. Suggest creating a schedule for physical activity; it doesn’t have to be strenuous but should be consistent.
- Health Goals: Discover your patients’ health and weight-loss goals and work together to to achieve them. Start with one or two measurable actions to make the process feel less daunting and more attainable.
What Are the Next Steps?
Ensuring patients who are overweight or have obesity are cared for physically and emotionally is of the utmost importance. One bad interaction with a clinician can be extremely harmful to this patient population, and it could lead to patients avoiding medical care entirely. That’s why clinicians need to be well-versed in empathetic care and have resources available to help patients struggling with their weight.
The U.S. Preventive Services Task Force recommends referring patients with a BMI of 30 or higher to intensive, multicomponent behavioral interventions and obesity specialists. This makes it possible for a team of healthcare professionals to treat the many facets of the disease of obesity and create a comprehensive plan that includes diet and nutrition, physical activity, counseling, and follow-up care.
Whether patients are ready to make lifestyle changes to improve their health or not, it’s up to clinicians to follow their cues. By knowing the experts in your area and having baseline clinical knowledge of obesity care, you can put patients on a path to a healthier weight and lifestyle. Remember, bedside manner really matters; compassionate care can go a long way to helping more patients get the medical attention they need.