Discussing Weight Issues Sensitively With Your Patients
M3 Global Newsdesk Oct 27, 2024
The article examines the discomfort many patients feel about unsolicited weight advice and promotes the "Your Weight Matters" campaign, which empowers patients to initiate weight-related discussions during medical visits.
Key takeaways
- Many physicians know that patients get upset when given unsolicited advice about their weight from their doctors.
- Despite the hesitation, weight discussions are an important part of wellness exams. A new campaign, the "Your Weight Matters" challenge from the OAC, aims to encourage patients to start the conversation instead.
- Physicians can prompt patients to discuss weight concerns on their terms.
Body weight is a touchy subject. While some clinicians are quick to bring it up at every appointment, others would rather avoid it at all costs. In some cases, patients want to talk about it, but they’re not sure how.
We did some digging to see what patients think when physicians talk about their weight. In light of a new challenge—an initiative from the Obesity Action Coalition (OAC), called “Your Weight Matters,”[1] which aims to reduce patient hesitation about broaching the topic in the clinic—perhaps it’s time for physicians to stop talking and start listening.
What patients are saying
Let's first take a closer look at the impetus for the new challenge and other initiatives designed to get patients more comfortable talking about weight.
Many patients turn to online forums when upset by an interaction with their healthcare provider. Here’s what patients have shared on Reddit about getting unsolicited weight loss advice from their gynaecologists.[2]
One user said, “Just had an embarrassing appointment where my gynaecologist was harping on my weight. But it was not for any reason related to my reproductive health. […] She repeatedly said that I need to lose weight because my ‘knees will give out’ when I’m older […] and I nodded but now I’m thinking [what] does that have to do with my reproductive health?’ She didn’t offer guidance at all, as if losing 100 pounds is just a matter of wanting to. I am really angry and not sure what to do.”[2]
Others expressed similar feelings of helplessness. “Every time I went to the doctor, they gave me the same speech about eating right and exercising," said one user.
"Even though I do those things, hearing it over and over [will] not magically make me drop weight."
— Patient post on Reddit
"Then I was getting referrals to a bariatric surgeon from every [doctor] I saw, even though I was not interested," the post continued. "I have PCOS and Hashimoto’s, so my weight will likely never be what doctors want [to see]. But it’s still pretty disheartening when my GYNECOLOGIST(!!!!!) recommended I try fasting (this was a week after I finished eating disorder treatment) when I was there to get an ultrasound for my PCOS.”[2]
Positive stories patients have shared
On the other side, Redditors have also described instances where they were pleasantly surprised by how clinicians handled the weight discussion.
“My gynaecologist treated me through cyst removal, ovarian cancer treatment […] two pregnancies and recently a hysterectomy with prolapse repair. [My doctor] has mentioned my weight twice that I can remember. One was discussing delivery options during my first pregnancy and was limited to ‘We would ask you to have a hospital delivery, which is recommended for mothers with a slightly higher BMI combined with your complex history,’ and once during a discussion around HRT, ‘I would recommend patches rather than gel as I have found they deliver a more measured dose if you are carrying a little extra weight.’
"It was handled very kindly and respectfully both times. I was never made to feel small or judged. "
— Patient post on Reddit
"I’m a grown woman. I know I’m fat. I know my health would benefit from weight loss. Being condescendingly told to lose 100 pounds [is] not helpful or respectful,” the post concluded.[2]
Another shared:
“My OB saw me through two pregnancies, and I am a good 100+ lb overweight. She never brought it up. I did, though, because I felt guilty for my extra weight making my pregnancies higher risk. I was always telling her how I was eating healthy and working to lose weight. One time, she looked me right in my eyes and told me that was good, but at any weight, she would be taking care of me and my babies."[2]
"I could have cried. That is how a good doctor should be."
— Patient post on Reddit
How the new challenge aims to help
Patients want to choose whether to address their body weight during doctor’s visits. The Your Weight Matters challenge offers online resources to equip patients with tools to talk about their weight concerns.
The goal of this initiative is to increase weight-related conversations in the doctor’s office without patients feeling judged or stigmatised by their doctors.
Patients are encouraged to sign up for the challenge online and receive a free toolkit that includes education on weight loss interventions and lifestyle modifications, instructions on how to measure their BMI, and a list of questions to ask their providers.[3]
New obesity treatments are available to tackle excess weight, making today’s weight loss consults different than in years past. Not surprisingly, big names like Eli Lilly, Novo Nordisk, Amgen, Boehringer Ingelheim, and Currax are excited to “fuel support” for the campaign, although the nature and extent of their involvement are undisclosed.
These companies have either released or are working on blockbuster weight management drugs. They’re eager for patients to “ask their doctor” about treatments they want to sell.[1]
Let patients take the lead
If research on behaviour change has taught us anything, we know change must come from the individual.
Lecturing on weight issues isn’t likely to do any good if it’s not something the patient is requesting. Chances are, they’ve heard it all before. This approach can easily backfire and make overweight patients to reluctant to seek care.[4]
The Your Weight Matters campaign can positively affect dynamics in the exam room. When patients bring up their weight, it takes some of the onus off physicians. If patients don’t bring it up, doctors may assume they’re either too shy to discuss it, or they don’t want to. In this case, clinicians can introduce the topic by telling patients about the Your Weight Matters challenge and letting them decide whether to discuss it further, now or later.
What this means for you
Patients aren’t happy when doctors discuss their weight without prompting. Instead, patients should be encouraged to bring it up themselves if desired. Physicians can help by saying, “Some people want to discuss their weight but aren’t sure how. I can share resources to help you start the conversation if you’d like.”
Disclaimer: This story is contributed by Anastasia Climan and is a part of our Global Content Initiative, where we feature selected stories from our Global network which we believe would be most useful and informative to our doctor members.
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