Engaging the Obese Patient

Starting a dialogue that leads to healing.

Primary care providers are in an ideal position to offer guidance to overweight and obese patients. A cornerstone of effective treatment of obesity is grounded not only in the medical treatment of the disease, but also in the ability to provide empathetic provider-patient communication.

The 7 Most Important Communication Behaviors*

A provider should be:

• Empathetic
• Confident
• Humane
• Personal
• Forthright
• Respectful
• Thorough

Step 1: Open the discussion

Find out if the patient is willing to talk about weight at all. You can start in the context of the problems your patient has already brought up during the visit. Remain non-judgmental as you express concerns about the ways the patient’s weight may affects his or her health.

Step 2: Judge the patient’s readiness

If your patient isn’t willing to acknowledge that his or her weight is a problem, he or she is unlikely to accept help.

If your patient seems concerned about his or her weight:

Step 3: Form a patient-physician partnership

While the steps required for obesity management are comprehensive, it’s important to start small. Ask your patient about the steps they’ve taken in the past to lose weight. Ask them what changes they could make in their diet or exercise to improve their health.

“Shannon, are there any activities you’d like to try to be more active?”

First Steps
Help your patients take an active role in obesity management by:

• Self-monitoring diet and exercise
• Control environmental stimulus
• Setting goals
• Staying positive
• Solving problems

If your patient doesn’t feel his or her weight is a problem:

Step 4: Let the patient know you’re available

Because overweight and obese patients encounter so much prejudice and bias, it’s important to offer unconditional acceptance and avoid making disapproving statements. Acknowledge the challenges to weight loss, and offer praise for the efforts they have made to improve their health or lifestyle. Let them know that if or when they want to make a plan, you’re there to help.
“I’m hearing that you don’t see your weight as an issue. In the future, if you do find it’s keeping you from doing the things you want to do, let me know. We could talk about medical options and strategies that could make a difference.”

Step 5: Make a plan

Help your patient make a realistic plan with specific steps to implement these changes. Together, create a system of accountability, such as a daily food diary or exercise log. If your patient has already been frustrated with weight loss programs or techniques, consider recommending help from a bariatric weight-loss practice such as New Dimensions that can offer specialized support and surgical and non-surgical tools to help your patient achieve success.

Step 6: Check in regularly

Support your patient’s effort by offering regular opportunities to monitor his or her progress. Congratulate your patient for the efforts they’ve made, even if they aren’t seeing results. If your patient is frustrated, consider recommending help from a bariatric weight-loss practice such as New Dimensions that can offer specialized support and surgical and non-surgical tools to help your patient achieve success.

*Mayo Clinic Study

** This page based on the AMA’s guidelines for talking to patients about obesity: Assessment and Management of Adult Obesity: A Primer for Physicians