​Decreasing weight in individuals who have obesity can improve diabetes, heart disease, fertility, liver health, mental health, ability to participate in physical activity, work, productivity, and overall quality of life and longevity. With just a 5% decrease in weight loss, patients see health benefits (NIH). Every provider should be interested and educated about obesity as it affects 30% of California's population (CDC).

Meeting this challenge and being able to help the patient may mean a change in perspective for the provider. The AMA, CDC, and other organizations acknowledge obesity as a chronic disease. You have to eat less and exercise more is not a complete picture of the disease. Nor is it a personal failure that people have gained weight or can't get it off. In order to improve the condition, providers need to embrace the idea that obesity is a chronic disease and address it as any other chronic illness. Visit our Resources Page for more provider resources.

The Patient Journey

Empathy is the key to working with all patients struggling with excess weight. Patients dealing with obesity have faced possibly years of being told their weight is due to a failure in their character.  You are potentially dealing with a sensitive, battered, depressed, mortified patient who has suffered loss and rejection in various ways due to their weight. It is not a surprise that the patient retreats emotionally the moment you say anything about weight, particularly if you call them obese. 

What Can You Say?

'Ask your patient what their concerns are, then address those concerns. If the subject of weight doesn't come up, talk about how excess weight affects the patient's overall health. Tell them how obesity has been connected to 30 cancers, diabetes, heart disease, and more. Plan to talk to all patients about it. Talking to everyone about the impacts of excess weight and/or reviewing everyone for weight issues will allow you to focus on the illness rather than the patient's fault. It is important to frame obesity as a chronic medical condition. Research suggests this fosters improved provider-patient relationships and improved self-esteem in the patient (Medscape).

​After addressing the issue broadly, the conversation about their weight can start something like this: Your weight is higher than we think is healthy for you. (Using the term obesity often puts patients on the defensive.)

What Can You Do?

  1. Few providers are fully educated about obesity. Visit STOP Obesity Alliance to learn about Provider Competencies.
  2. Have a thorough discussion about the patient that includes not just diet and exercise but a full review of health issues. Also, use the conversation to learn:
  • How heredity may be involved
  • ​About the patient's access to and ability to exercise
  • If they have support for their efforts from loved ones 
  • What the culture around food is in their household and other applicable issues.
3. Be sure to ask the patient to take tests to determine what might be hindering the ability to lose weight. The tests may include:
  • Diabetes-related tests, such as fasting blood glucose and hemoglobin A1c
  • Lipid and cholesterol levels
  • Thyroid-stimulating hormone levels
  • Liver blood tests
  • Kidney function blood tests
  • Vitamin D levels
  • Electrocardiogram
  • Exercise testing
  • Resting metabolic rate (Hopkins)
Based on your patient’s personal history and medical needs, you may choose to do additional tests.
4. Follow up: Set the next appointment before the patient leaves.
​5. Once you have all the test results back, you can create a plan with your patient to determine what lifestyle changes they will make, what support they need (mental and behavioral health), what progress looks like, if treatment is recommended what that will be (medications, surgeries, etc.) and when you will check in next.

cHope is an alliance of the
California Chronic Care Coalition
1001 K Street, 6th Floor
Sacramento, CA 95814
​The California Chronic Care Coalition (CCCC) is a unique alliance of more than 30 leading consumer health organizations and provider groups that promote the collaborative work of policy makers, industry leaders, providers, and consumers to improve the health of Californians with chronic conditions. We envision a system of care that is accessible, affordable, and of a high-quality that emphasizes prevention, coordinated care, and the patient’s wellness and longevity.
The information found here including but not limited to, text, graphics, images and all other material contained on this website is for informational purposes only and is not intended to provide medical advice, diagnosis or treatment recommendations. Talk to your doctor or a qualified healthcare provider about any health or medical questions you may have, and to determine the correct course of action for your individual needs.