Written on behalf of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
March is National Nutrition Month—a good time to talk with patients about weight management and how eating and physical activity habits can affect body weight and health. But talking about weight can be difficult for both patients and health care providers. The following tips and resources may help pave the way for more successful patient/provider interactions.
How to Raise the Topic
Before you bring up topics related to weight, address your patients’ main health concerns, such as a sore throat. Let patients talk about other issues that may be affecting their physical or emotional health, such as family or work issues. Mention health risks associated with overweight and obesity. Then ask patients if you could talk with them about their general health, including weight. Open the discussion about weight in a respectful and nonjudgmental way. Patients may feel more comfortable and be more open if they feel respected.
Remember That Words Matter
Research has shown patients prefer the terms “weight” (first) and “BMI” (second) when talking about obesity, and dislike the terms “fatness,” “excess fat,” and “obesity.” Preferred and non-preferred terms generally were the same across social and economic factors. Using terms patients prefer may improve patient communication and care. You may want to say something like:
- “Mr. Jones, could we talk about your weight today?” or
- “Mr. Jones, how are you feeling about your weight at this time?”
Be alert and sensitive to cultural differences your patients may have about weight, favorite foods, social norms and practices, and related issues. For example, patients who think they are at a normal weight within their culture might respond better to a clinician’s suggestions for maintaining, rather than losing, weight.
Ask Questions to Encourage Discussion
Patients who aren’t ready to attempt weight loss may still benefit from talking with their health care provider about the advantages of healthy eating and regular physical activity. Try asking some of the questions below to encourage a dialogue and get patients thinking about changing their lifestyle habits.
For Healthy Eating
- “I’d like to learn more about your eating habits. What kinds of foods and beverages 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 do you eat for other reasons as well, such as feeling stressed or bored?”
- “When is the amount of food and beverages you eat and drink likely to change (for example, when you eat out, or at work or family celebrations)?”
- “Do you think keeping a journal could help you keep track of how much you eat, drink, and exercise?”
For Physical Activity
- “When would be the best time of day or evening for you to be active?”
- “What kinds of activities do you enjoy? Do you like walking? Seated aerobics?
- “Do you prefer activities you can do alone, with someone else, or in a group?”
- “How much time do you spend sitting each day? Would you like to try to work some physical activity into your daily routine?”
- [If yes], what steps would you follow to be active? Would you try a fitness video in the morning before work? Or walk at lunch with a colleague?
Move from Discussion to Action
If patients are willing, talk with them about developing a plan that meets their needs and supports their goals to make small changes to improve their health. For tips on how to change habits, you may want to refer them to Changing Your Habits for Better Health on the NIDDK website. Many patients may benefit from a referral to a registered dietitian or structured weight-loss program. Some evidence-based, commercial weight-loss programs may also be helpful.
If your patients aren’t interested in or ready to commit to a weight-loss plan, talk with them about avoiding further weight gain by trying to move more each day and cutting back on sugar-sweetened beverages, unhealthy fats, and salt. Consult the quick reference for health care professionals on the Physical Activity Guidelines for Americans and the at-a-glance summary of the 2015-2020 Dietary Guidelines.
The NIDDK has tools and information to help adults and youth change their habits and achieve their health goals by getting and staying active, eating healthy, and managing their weight. The NIDDK sponsors research on how eating, physical activity, and other factors affect health and weight; and how to treat weight-related health problems such as diabetes and chronic kidney disease. Follow the NIDDK on Facebook and Twitter for updates about resources, research, and other activities.
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