alt

Gloria's BMI is 39

Tools to support conversations with your patients about obesity

For people who have overweight or obesity, lifestyle interventions can be effective for weight management.Empathetic and supportive discussions may help patients to address the challenges of weight management.2

 

Click on the below sections to explore talking points and resources to shape your discussions with your patients. 

Working with your patients: five key areas


1. How do I initiate a discussion about obesity?

The complex and sensitive nature of obesity can make conversations difficult to have with patients. An empathetic approach and asking permission is a helpful starting point. Results from the ACTION Study showed that two thirds of people with obesity would like their healthcare professional to bring up their weight.4

Research indicates that when healthcare 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.2

To initiate a conversation with patients about their weight, it is important to first ask for permission.5 Without permission, talking about weight may be a sensitive and unwelcome topic.


2. What is a 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:5,9

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

Main components and goals of a focused weight-history discussion

The following talking points and questions may be helpful to achieve a successful weight history discussion.

Changes in weight over time

Everyone gains weight differently. Understanding how and why your patient’s weight has changed can provide insight into weight-gain causes.9

 

Factors in weight changes

This discussion involves eliciting your patient's perceptions of causes as well as connecting any past medical causes to changes in weight.9

Descriptions of past weight-loss efforts

Discuss and understand your patient's past efforts with weight loss, including specific programmes or plans, duration and results.1

Current habits

A discussion about your patient's current eating and activity habits and how they might feel about changing their current habits.10,11

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. Upon completion of the tool you will receive a weight history report with your patient’s short and long term goals mapped out. 

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

3. How do I set suitable weight management goals with my patients?

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.5 Try setting goals that are connected to your patients’ values and aspirations. For example, connect the goal of engaging in more physical activity to activities they can do with their children or family, such as going for a walk once a day.  

 

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

4. How do I discuss treatment options with my patients?

When discussing treatment for weight management with your patients, healthy eating and physical activity should always be included alongside medical or surgical treatment.12 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.

Patients should be encouraged to keep a food and physical activity journal to keep track of what they consume and their activity levels. Also, ask them to record things like:12

  • 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 people with obesity make decisions about food, you and your patients will be able to identify areas for change. People with obesity should be encouraged to bring their journal to each appointment to discuss general patterns. Healthcare 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.

5. How can I ensure my patients feel comfortable in my office?

Research shows that patients with excess weight feel stigmatised in many areas of their lives, including healthcare settings.16 The language you use and your office environment are key components of successful weight management.