Losing weight is viewed a difficult
and often unsuccessful endeavor
for most people who are overweight
or obese. The good news is that physicians and other healthcare professionals are in a position to play an active role in helping to educate patients about realistic weight loss goals and appropriate strategies.
And studies have shown that many patients are not only comfortable speaking with their physician about weight management but also show a greater response to their advice by actually attempting to lose weight. Approaching this subject with respect and empathy can go a long way in starting the conversation.

Step One: Give your patients permission to talk about their weight and set a positive tone
Most importantly, establish a comfortable rapport with your patients. Ask for permission to discuss weight issues and use terms such as “weight,” “excess weight,” and “BMI.” You can also:

• Ask the patient if he/she would be comfortable discussing general health issues related to weight.
• Ask about the patient’s weight history and how excess weight has affected his/her life.
• Be nonjudgmental.
• Express your concerns about the health risks associated with excess weight and how this is affecting the patient (for instance, review the patient’s BMI, waist circumference, and associated health risks).

Step Two: Is the patient ready?
Assess the patient’s reasons for wanting to lose weight and their “readiness” to make the necessary lifestyle changes to lose weight. Ask, on a scale of 1 to 10, with 10 being 100% ready to take action, how ready the patient is to lose weight.
An answer of:

• 1-4 means the patient does not intend to lose weight, so you could ask, “What would have to happen for you to be more ready?”
• 5-7 means the patient is ambivalent about taking action to lose weight. Don’t judge the patient’s ambivalence but invite the patient to bring up the subject at any time in the future.
• 8-10 means the patient is very willing to take action about his/her weight.

Step Three: Work together
Overweight patients welcome assistance in understanding their weight loss options and in setting up a personalized diet and physical activity plan.  Here’s how you can help:

• Speak about obesity as a medical condition. Explain that even a modest weight loss of 5% to 10% of initial weight—just 10 to 20 pounds--can make a big difference in reducing health risks.
• Ask the patient if he/she would like help with setting goals and developing a personalized action plan, including specific recommendations for a reduced-calorie diet and increased physical activity.
• Select two or three measurable, achievable goals and discuss steps needed to achieve them.
• Arrange for follow up.