I start by asking how the patients found us, were they referred to our medical clinic. I let them tell their weight loss/weight gain story. We use the term "patients have obesity" not "patients are obese." I listen, and if I have to at the end, I tell them we are the least judgmental people they have ever met. I tell them I am like a detective: I look for all the reasons that aren't their fault such as side effects of medications, or I am going to order some labs, or may I perform a free genetic study like 23 and Me? Patients seem so relieved to find themselves in a safe place.

I like to empower the patient and have them give ideas on things they can change. I also like to let them know they are not alone. I am here to help them on their journey.
I also like to stress that being obese does not have to define them.

When extraordinarily OW patients come to me for lower extremity pain, I explain to them that I can temporarily manage their pain, but bottomline we'd need to address the cause... we talk about their painfree goals, and the other positive health benefits as well as personal & social goals. If they have comorbidities, I briefly touch on it but try to turn it around to positivity. I exercise empathy, especially when they automatically want to be defensive, emotional or defeated.

I use words such as schedule or meal plan instead of diet. Will let patients discuss their goals of weight loss and then ask them what they have in mind, I can then discuss options. Will sometimes choose a calorie count and state this is what other have had great success with.

Obesity is an illness-usually there are underlying reasons for excessive eating and weight need to address these issues too.being supportive is crucial as weight loss can be very slow and patients get discouraged.Requies group efforts by PCM, nutritionist and behavioral health counselor.

Explaining the benefits of weight loss, cardiovascular benefits, lower risk cancer, promoting healthy diet, explaining the different ways to help weight reduction

IT IS UNFORTUNATE THAT THIS IS STILL AN ISSUE. WE AS HEALTHCARE PROVIDERS SHOULD KNOW AS WELL AS ANYONE THAT WEIGHT SHAMING DOES NOTHING TO FIX THE PROBLEM. BE COMPASSIONATE AND GIVE PATIENTS REASONABLE OPTIONS AND GOALS THAT THEY CAN STICK TO.

I try to point out a genetic link by asking about parents, siblings, grandparents and obesity. I focus on it being a national problem and not an individual issue. Provide understanding, support and encouragement to the problem and provide understanding to their situation. Discuss there are many avenues to take to achieve their objective and try to find what would work best for them.

I believe it is important to address the individual in a positive and patient-centric manner by employing compassionate curiosity about their thoughts on weight and its impact on their wellbeing and health outcomes. It is important to obtain their thoughts, feelings, concerns, consent, and goals. I always remind the individual that we are a team and they have decision making capacity in the patient-provider relationship. I employ non-judgmental language, and I encourage them by reinforcing that today’s investment in their health will result in their future health outcome dividends.

I use the 5 A approach to address obesity .The 5 As (ask, assess, advise, agree, and assist), ask permission to discuss weight; be nonjudgmental and explore the patient's readiness for change. About 10% of my clinic visit are just focused on Weight. . I have found the comprehensive approach to be the most beneficial . This includes not only dietary and physical activity interventions but also addressing psychological factors, sleep, stress, and where appropriate, pharmacotherapy or bariatric surgery.

Weight management is not an individual choice and have to be approached from a family point of view; learn the habits of the family (who cooks, where they eat on the weekends, ...) and proposed for the whole family to be involved (whether or not the family needs to loose weight or not).

Treating obesity in my opinion definitely has to be individualized. You have to talk with the patient first about their mind set. How do they feel about their weight, eating habits. If they have any medical conditions, how does this affect those conditions. Of the patient is ready for this weight loss journey most importantly. I feel medication helps, but in of itself is not enough. If they carry on with the same lifestyle, chances of success are minimal. When patients are ready for a change, we talk about every aspect of it. Diet, exercise, mental aspects as well as medication support. When all of these are taken into consideration, our chances for success improves tremendously. I have had patients on injectables to help with weight loss. Those who did more than just take the medication saw great improvements and were able to sustain it. On the other hand, those who focused on medication only saw weight loss in the first few weeks, then plateaued and even gained the weight back. My conclusion, it has to be balanced. Address every aspect and create a partnership with the patient and follow up for accountability.

I treat and tell my patients Obesity is a medical condition like any other medical conditions. I teach them ways to eat healthy and exercise choices depending on their schedule. we discuss life style as well as medications just like any other medical condition. I encourage them to make a follow up visit to make further recommendations depending on their progress. I beleive it is a team approach.

I talk to patients about what their goals are and what has been a barrier in achieving those goals. Though I work in specialty (oncology), weight management is a common discussion.

i feel it is most important to ask patient where their knowledge of obesity related disease lies, how they perceive their health as poor, fair, good, great and where they are at in their readiness to change their health.
labs and family history also paint the picture as well as mental health and child hood trauma/ptsd related to their weight etc.
i am passionate about preventative medicine and this topic is near and dear to my heart. thank you for giving me this opportunity

Brianna Garvie PAC

I approach the topic of weight management the way that I would address any chronic illness. We would never just ignore type 2 diabetes or asthma, etc. and insistent that patients try harder to make their medical conditions resolve without intervention. Similarly overweight or BMI > 30 will not spontaneously go into remission without lifestyle and medical interventions. If patients aren't ready to discuss at the initial visit, I'll schedule a close f/u to continue the discussion. Marta Peimer, FNP-BC

I always ask pts' permission to discuss their weight concerns. I also heard a lot of stories from the pts that they are frequently blamed for their weight and told "just exercise and eat right" by multiple providers. if pts do not want to discuss their weight i tell them to call the office for a separate appt when they are ready

This can be a touchy subject for many women. I try to wait until I have an established relationship with the patient before I approach the topic. With the new weight loss drugs there are more options for patients. This helps take the burden of the weight loss of the patient and turns it into a partnership.

Open ended questions. Try to focus on diet and exercise changes.

I have a BMI chart in exam room and I point to the patient's BMI and evaluate the response and ask of they would like to further discuss this topic. That way I allow the patient to have control over the discussion

Obesity is definitely is definitely something I see and manage head on in my steatohepatitis patients ( which have become the major risk for cirrhosis / cancer and need for liver transplant

I ask my patients as we end their visit how they are doing with their weight. Depending on their response I can move on to further discussion about treatment options. I am excited that we have new treatment options such as wegovi. I am using it and other meds in a number of patients with great success. I share that experience with patients who are considering medical treatment. It gives us both some hope that they can lose weight and improve their health.

Obesity is regarded as chronic illness just like HTN , Diabetes , and Hyperlipidemia and that is the perspective that should be discussed with the obsese pts and any body around us ! I tell them that being an obsese is not their fault and it is a metabolic disorder which needs to be managed with medicines , surgery and behaviour modifications and there is more help avaialble than ever in the history of medicine Once an medical objectivity has been brought to the discussion and you have their confidence that you are going to help them with out any bias that is when you see the improvement ! biggest challenge is still convincing them to have the bariatric surgery done which is the most effective intervention when pt has to lose more than 100 pounds as pts misconceptions about the safety of the surgery are there and the lack of the insurance coverage for bariatric surgey in most cases ! So once you manage obesity as well defined metabolic problem list objectively with the subjective realization of the same it becomes conducive to intervene with pharmaceutical and behavior modifications ! Once you are obese you will have to manage as a life long process as for any other metabolic disease and that is the challenge in practice of medicine and for the patients

Promoting collaboration and empathy in treating patients who are overweight or obese is crucial to ensure a patient-centric approach. Here are some strategies: 1. Non-judgmental Communication: Use neutral, non-stigmatizing language. For example, use "people with obesity" instead of "obese people" to emphasize the person first, not their condition. Avoid blaming the patient for their weight and instead focus on the complex interplay of genetics, environment, and behavior that contributes to obesity. 2. Empathetic Listening: Understand the patient's perspective, their struggles, and their experiences. This can help build a strong therapeutic alliance and make the patient feel heard and understood. 3. Shared Decision Making: Involve the patient in the decision-making process. Discuss the benefits and risks of various treatment options, and respect their preferences and values. This can enhance patient engagement and adherence to treatment plans. 4. Comprehensive Approach: Recognize that obesity is a chronic condition that requires a multifaceted approach. This includes not only dietary and physical activity interventions but also addressing psychological factors, sleep, stress, and where appropriate, pharmacotherapy or bariatric surgery. 5. Provide Support: Encourage patients, acknowledge their efforts, and celebrate their successes, no matter how small. This can boost their motivation and self-efficacy. 6. Education: Educate patients about the health risks associated with obesity, but also emphasize the health benefits of modest weight loss, which can be as little as 5-10% of body weight. 7. Interdisciplinary Team: Collaborate with dietitians, physiotherapists, psychologists, and other healthcare professionals to provide comprehensive care. 8. Advocate: Challenge weight bias and discrimination in healthcare settings and advocate for policies that support obesity prevention and treatment. By fostering an environment of empathy and respect, we can help to reduce weight stigma and improve health outcomes for patients with obesity.

Weight is a topic I bring up for discussion at end of visit.
By that time I know patient better.
If patient gets defensive right away I drop the topic till I get to know patient better and develop a trusting relationship.

I always try to maintain a positive attitude with my patients who are overweight to instill a “can do” attitude in them enabling them to lose the weight.

I always try to maintain a positive attitude with my patients who are overweight to instill a “can do” attitude in them enabling them to lose the weight.

I always tell my patients to “be a tryer”!

I've given this topic alot of thought, including writing an article about when Family Doctors put overweight and obesity on the medical problem list.

It is critical to treat all patients with respect and care related to their weight.

Peggy R. Cyr MD

you alway have to use positive encouragement and emphasize everything that they are traying to do to loose weight. you tell them it is hard to loose weight eventually you will see a difference
debbie