Intended for non-US health care professionals

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Gloria's BMI is 39

How to start a conversation

For those patients who meet the criteria for having obesity, or are overweight with weight-related comorbidities, lifestyle interventions can be effective for weight management.1

Empathetic and supportive discussions may help patients to address the challenges of weight management.


Getting started: guiding a structured discussion

The discussion guide employs a simple structure:

  1. Ask for permission and initiate dialogue

  2. Focus on weight history

  3. Set individual goals

  4. Discuss treatment options

Throughout this site, and in the associated resources, there are suggested talking points and questions to help you shape discussions with your patients.

Look for these outlined areas throughout the Rethink your obesity discussions guide for suggested talking points and questions that you can refer to directly in discussion with patients. 


1. Initiating discussion through getting permission

The complex and sensitive nature of the disease of obesity can make conversations difficult to have with patients. An empathetic approach and asking permission is a helpful starting point.

Research indicates that when health care professionals employ an empathetic approach, and other techniques consistent with motivational interviewing, patients are more likely to attempt weight loss through changes in eating and activity habits.3

To initiate a conversation with patients about excess weight, it is important to first ask for permission.4 Without permission, talking about weight may be a sensitive and unwelcome topic.


Advising on health risks and excess weight

It is recommended that you advise about the health risks associated with obesity.4

To balance the discussion of health risks associated with excess weight, consider advising your patient on how even modest, sustained, weight loss of 5–10% can improve their health and reduce risks of comorbidities.4

Talking points and questions

Do you have any questions about what it means to have a high BMI?


BMI is a measurement that helps determine if a person is carrying excess weight for his or her height.5 BMI isn't a complete measure of health, so we look at other measures like waist circumference, blood pressure and cholesterol levels that indicate what should be addressed about your health4

Because of your weight, you are also at risk of developing several weight-related complications including diabetes, high blood pressure and other cardiovascular complications6

With weight loss of as little as 5% of your body weight, you can improve your health and reduce your risks of many other complications7

Achieving 5‒10% weight loss is a process that begins with making a few specific lifestyle changes to your eating habits, increasing your physical activity and discussing other treatment options8

I can support you in your efforts to improve your health and lose weight. Is that something you would like?  

Following initiating a discussion about weight and the risks of excess weight, explain that the next step could be to take a weight history in order to set goals for individual weight management.


2. Focused weight-history discussion

A weight-history discussion is intended to complement a full clinical and physical assessment to identify metabolic, genetic and hormonal factors as well as medications that may be the reasons for weight gain. A successful weight-history discussion can result in:4,8

Assessment of root causes that influence eating and activity behaviours

Understanding of past efforts, challenges and previous weight-loss success

A basis for setting weight-loss goals for each patient


3. Goal setting for weight management

Setting individual goals

A discussion about goal setting is a way to help your patients connect their goals with the changes they can make for better weight management. Align with your patients on realistic and individualised goals as a first step towards achieving meaningful weight loss.4

 

Discussing goal setting

You may want to start by discussing the "big picture," or the long-term ultimate goals that your patients may have in mind. It can be helpful to refer to the responses to the initial questions about how weight affects medical, physical, emotional and day-to-day well-being and their plans or goals for their lifestyle in the future.

 

Talk about the big picture

There are several things you can do, working with your patients, to help them set goals and work towards achieving them. To begin the process, some questions to consider asking are:

  • Ultimately, what do you want to achieve? If you think about the big picture of your life, what do you want it to look like? Health? Travel?
  • Do you have any general goals for overall well-being or how you want to feel better physically, emotionally and medically?
  • Do you have a certain amount of weight that you want to lose?
  • Considering your ultimate goals, we can work together to take the first steps toward what is realistic for you to achieve for health and weight

Chart your patient's personal weight history

Use our interactive tool to help you chart your patient’s weight history and set appropriate goals.

Follow the onscreen instructions and work through the screens entering data in the relevant fields. Click Start to begin and use the Next and Back buttons to move between screens.

Chart your patient's personal weight history

1
Enter current weight
2
Enter key weight change events
3
Enter short-term weight goal
4
Enter long-term weight goal
5
Generate report and give the printed copy to the patient
Start

Weight history

Back
Next Step

Setting short-term goal

What is your patient's short-term goal?

What I want to achieve


Enter the target weight

kg
How will your patient achieve their short-term goal:(maximum of 4)

Other, please specify below

When will I achieve my short-term goal?

Back
Next Step

Setting long-term goal

What is your patient's long-term goal?

What I want to achieve


Enter the target weight

kg
How will your patient achieve their long-term goal:(maximum of 4)

Other, please specify below

When will I achieve my long-term goal:

Back
Next Step

Goal setting summary

Name/Initials:

Date:

Your weight history

Short-term goal

What I want to achieve

How I plan to achieve my short-term goal:

Long-term goal

What I want to achieve

How I plan to achieve my long-term goal:

I will achieve this by:

Follow-up visit:

I will achieve this by:

Follow-up visit:

Back

4. Discussing treatment options

When discussing treatment for weight management with your patients, incorporating healthy eating and activity habits should always be included with any potential discussion on medical or surgical treatment options available.11 Patients who have struggled with excess weight may take some time to adopt new healthy habits. As you approach the topic of healthy eating and activity habits with your patients, focus on achievable steps they can take toward sustainable lifestyle changes.

Healthy eating and physical activity must be part of any weight-loss intervention and treatment plan, but are not always sufficient to maintain weight loss.11

 

Patients should be encouraged to keep a food and physical activity journal to keep track of all the foods and drinks they consume. Also, ask them to record things like:11

  • Hunger level before and after eating
  • Time spent active and what types of activity
  • Overall feelings about the lifestyle changes they are making

By recording the situations and feelings in which patients make decisions about food, patients are able to identify areas for change that drive food-related decisions. Patients should be encouraged to bring their journal to each appointment to discuss general patterns. Health care professionals are encouraged to provide positive feedback for progress made.

We have developed a handout to help guide discussions with your patients around healthier eating and increased physical activity.