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[8 min read] Talking to your patients about weight management
As a general practitioner, you are in an ideal position to talk with patients about weight management. Here is how you can address this sensitive topic in your day to day practice.
Why talk with your patients about their weight?
Around 63 per cent of Australian adults are obese. Excess weight puts people at risk of developing diabetes, heart disease, kidney disease, stroke, cancer, and a host of other chronic conditions. Research shows that even a modest weight loss of 5 per cent can be beneficial to a patient’s health.
Talking with your patients about their weight can promote behaviour change. They may need help setting and reaching weight loss goals, forming an exercise plan, or developing a nutritionally balanced diet. By working with patients as partners, you can play a key role in helping them improve their health.
Read more about the importance of nutrition care in general practice.
Which patients benefit most?
Regularly measuring your patients’ BMI may help you identify who may benefit from weight counselling. Some medications used for psychiatric disorders, diabetes, or other conditions may contribute to weight gain or difficulty losing weight. Review your patients’ medications and consider substituting where medically appropriate.
Patients do not want their GP to assume all their problems are weight-related. It is important to address your patients’ main health concerns first, letting them talk about other issues that may be affecting their physical or emotional health.
Open the discussion about weight in a respectful and non-judgemental way. Patients may be more receptive if they feel respected. Mention the health risks associated with carrying excess fat, then ask your patients if you can talk with them about their general health, including weight.
Research suggests that patients prefer the terms “weight” and “BMI” when talking about obesity, and dislike the terms “fatness”, “excess fat” and “obesity”. Using preferred terms may help improve patient communication. You could approach the subject with a question such as, “How are you feeling about your weight at this time?”
It is also important to be sensitive to cultural differences your patients may have about weight, food and social norms. For example, patients who think they are at a normal weight within their culture might respond better to your suggestions for maintaining, rather than losing, weight.
What other questions should you ask?
Try to determine whether your patients are willing to make lifestyle changes that might improve their health. Patients who are not yet ready to attempt weight loss may still benefit from talking with their GP about healthy eating and regular physical activity.
Ask patients about their eating and drinking patterns. Examples include:
- “What do you eat and drink on a typical day?”
- “What does ‘healthy eating’ mean to you?”
- “Do you eat only when you’re hungry, or when you feel stressed or bored?”
- “Does the amount you eat and drink ever change?”
- “Do you think a journal will help you track how much you eat, drink, and exercise?”
Besides good nutrition, exercise plays an important part in healthy weight. Remind your patients about the health benefits of being active on a regular basis. Examples of questions you might ask include:
- “When is the best time of day for you to be active?”
- “What kinds of activities do you enjoy?”
- “How much time do you spend sitting each day? Can we change this?”
How can you help your patients who need to lose weight?
Partner with your patients to develop a plan tailored to their individual needs and readiness for change. Consult practice guidelines for managing obesity and excess fat in adults, and encourage your patients to stick with the plan.
How can you help your patients set and stick with goals?
Help patients understand the stages of change and how weight management may improve health. Ask:
- “What are some goals you could set regarding your weight?”
- “What kind of changes would you be willing to start with?”
- “What kind of help would you like to meet your goals?”
Goals should be specific, measurable, achievable, realistic, and time-sensitive. For example, suggest a goal of walking 30 minutes a day, three days a week for two months, rather than a more general goal of becoming more active.
Once your patients determine their goals, they can begin to identify concrete actions or changes they can make to meet their weight goal over six months. Starting with two or three actions or changes may make them seem less overwhelming and more realistic.
When you see patients for follow-up visits, note their progress and point out any health improvements. Discuss setbacks and make suggestions for overcoming challenges. Your patients may want to set new goals or adjust existing goals to make them more realistic.
Read more recent research in medical nutrition management.