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How to talk to an obese patient about their weight?

Advise & Consent: Talking to Obese Patients About Their Weight 1 The Physician’s Own Barriers. Doctors often say that there is so much to cover in a visit... 2 Permission to Start the Conversation about Weight Management. 3 Motivational Interviewing. Physicians need to explore their own implicit assumptions...

Can measuring patient weight be used as a part of nutrition assessment?

Measuring patient weight is considered a routine assessment that is frequently delegated to unregistered staff. Yet patient weight is a fundamental part of nutrition assessment and may be used to calculate drug dosages and assess fluid balance.

Why should I record my patient’s weight?

Recording and documenting an accurate patient body weight is a fundamental part of any nutrition screening tool and is a valuable tool in monitoring fluid balance and calculating medication doses.

Should we weigh patients in routine admission assessments?

They suggested weighing patients used to be an integral part of the routine nursing admission assessment but increasing demands on qualified nurses has resulted in delegation to non-registered health professionals.

What advice would you give to an overweight person?

Healthy eating plan and regular physical activity. Changing your habits. Weight-management programs. Weight-loss medicines.

How do you talk to patients about their weight?

NIDDK continues with these tips for talking about weight:Address your patient's chief complaint first, independent of weight. ... Open the discussion. ... Decide if your patient is ready to control weight. ... Set a weight goal. ... Prescribe healthy eating and physical activity behaviors. ... Set realistic daily/weekly goals. ... Follow up.

How do you manage excessive weight gain?

Choose whole-grain carbs, fruits and vegetables, and always include lean or low-fat protein with meals and snacks. You'll feel fuller and be less likely to pick between meals. Experts recommend eating regular meals, paring down portions of high-fat and high-calorie foods, and never skipping breakfast.

How do you say a patient is overweight?

Obese patients from six diverse primary care practices rated the terms “fatness,” “excess fat,” “large size,” and “heaviness” as undesirable for describing excess weight.

How do you convince someone to lose weight?

Top 10 Ways to Help a Dieter SucceedBe a cheerleader, not a coach. ... Become an active part of their program. ... Help develop healthy incentives. ... Show them you care about the person, not the diet. ... When they've had a bad day, listen but don't judge.More items...•

How do you tell someone they need to lose weight?

The Don'tsDo not use shame.Do not force the issue.Do not frame the discussion around weight and food.Do not offer "helpful" weight loss hints.Do not monitor their food or exercise.Do not judge.Do remember that your loved one may already feel ashamed.Do speak about health and feelings.More items...•

How can you maintain a healthful weight?

You can reach and maintain a healthy weight if you:Follow a healthy diet, and if you are overweight or obese, reduce your daily intake by 500 calories for weight loss.Are physically active.Limit the time you spend being physically inactive.

How will you maintain a healthy weight give three ways and explain each?

Be as physically active as you can be. Swap out your usual foods for healthier alternatives. Stay hydrated with water and avoid drinks with added sugar. Set specific, realistic goals, such as three 15-minute walks per week.

What causes excess weight gain?

Poor sleep, sedentary activities, and eating too many processed or sugary foods are just some of the habits that may increase your risk of weight gain. Yet, a few simple steps — such as mindful eating, exercise, and focusing on whole foods — can help you reach your weight loss goals and improve your overall health.

How do you document obesity?

A patient with a BMI of >/= to 30 is considered obese, and a patient with a BMI of >/= to 40 is morbidly obese. These diagnoses can only be coded if they are documented by an attending physician.

How do you describe obesity?

Overweight and obesity are defined as abnormal or excessive fat accumulation that presents a risk to health. A body mass index (BMI) over 25 is considered overweight, and over 30 is obese.

What is the new word for obese?

In a new position statement, the American Association of Clinical Endocrinologists (AACE) and the American College of Endocrinology (ACE) have replaced the word “obesity” with “Adiposity-Based Chronic Disease” (ABCD).

Why do physicians need to explore their own implicit assumptions and biases about obesity?

Physicians need to explore their own implicit assumptions and biases about obesity to ensure that they don’t give patients a feeling of being judged, and move past their accustomed prescriptive approach in favor of a more collaborative effort called motivational interviewing.

Can doctors deflect weight?

Physicians can deflect some of the sensitivity about weight by asking permission to even bring it up. “Weight is a very personal issue that many patients have had to deal with their whole lives. They have had to deal with a lot of stigma and a lot of teasing,” Kahan says.

Is obesity a sensitive issue?

Obesity is such a sensitive issue that many physicians avoid discussing it. Here are some tips on the right (and wrong) ways to broach the subject. Talking to patients about their weight is a critical task that many physicians find difficult — and even embarrassing. Too many physicians find it so uncomfortable that they avoid it altogether.

What to ask before talking to a patient about weight?

Before asking patients if they wish to discuss their weight, mention the health risks associated with overweight and obesity. Ask patients if you could talk with them about their general health, including weight. Research has shown that patients prefer the terms “weight” (first) and “BMI” (second) when talking about obesity, ...

Why is it important to talk to a primary care physician about weight loss?

Studies show that talking with patients about weight loss may help promote behavior change. 2. Patients with overweight or obesity may want help setting and reaching weight-loss goals ...

What is the BMI of a person with obesity?

Some patients with severe obesity—a BMI ≥40 kg/m 2 or ≥35 kg/m 2 with comorbid conditions—may benefit from information on bariatric surgery or other weight-loss surgery. Be prepared to refer patients to a specialist who can help them decide if weight-loss surgery is an option for them.

What to do when you see patients for follow up?

When you see patients for follow-up visits, note their progress. Point out any health improvements, such as lower blood pressure and cholesterol levels. Improving health numbers, along with praise, may help motivate patients and boost self-esteem.

How long does it take to change behavior in obesity?

5 Lifestyle programs and counseling might include a thorough plan that uses behavior change strategies for at least 6 months to increase physical activity and improve healthy eating.

What is the BMI of a gastric band?

a BMI ≥35 kg/m 2, along with a serious health problem linked to obesity, such as type 2 diabetes, heart disease, or sleep apnea. a BMI ≥30 kg/m 2 with a serious health problem linked to obesity, for the laparoscopic adjustable gastric band only.

How to talk about physical activity?

To talk about physical activity, start with the health benefits of being active, even for short periods of time, on a regular basis. Consider asking your patients the following types of questions:

Why is it important to measure body weight?

Measuring body weight is vital for accurate prescribing of some drugs and monitoring of fluid balance. Weighing scales in hospital must be Class III category. Scales should be calibrated every year.

Is weight a one off observation?

Weight should not be considered as a one-off observation on admission but must be recognised as an important tool for ongoing assessment throughout the patient’s health journey and should be carried out by staff who have the appropriate knowledge and training. Key points.

Can you get accurate body weight?

It is not always possible to obtain an accurate body weight for all patients on admission to hospital. Patient acuity may demand that in some circumstances alternative measures of recording a body weight must beconsidered. In such cases, practitioners should: Ask the patient about their latest recorded weight;

Is weighing equipment required in healthcare?

In healthcare premises it is a legal requirement to have weighing equipment that is accurate and fit for purpose.

How much weight loss can you get from obesity pharmacotherapy?

For patients with BMI greater than 30 kg/m2(or 27–30 kg/m2with obesity-related comorbid conditions), obesity pharmacotherapy leads to as much as 15% weight loss in responders, with weight loss being maintained in several studies for several years90–92.

What are the factors that affect long term success in weight loss?

In other words, long-term success with a weight loss diet may have less to do with biology than factors such as the patient’s food environment, socioeconomics, medical comorbidities, and social support, as well as practical factors, such as developing cooking skills and managing job requirements.

What are the factors that contribute to weight loss?

Biological, behavioral, and environmental factors conspire to resist weight loss and promote regain. Treatment of obesity requires ongoing attention and support, and weight maintenance-specific counseling, to improve long-term weight management.

How much weight can I lose with aggressive counseling?

Studies show that even under the best of circumstances with aggressive counseling, average weight loss is between 5–10% of starting body weight – so you’re doing better than most! You’ve been able to get off several blood pressure medications and you no longer take the pain medicine for your back and knees.

How much kcal/d is needed for weight regain?

However, such a small difference in food intake behavior is somewhat misleading considering that prevention of weight regain requires about 300–500 kcal/d of increased persistent effort to counter the ongoing slowing of metabolism and increased appetite associated with the lost weight.

What is the role of diet composition?

The role of diet composition. The laws of thermodynamics dictate that the energy derived from macronutrients being oxidized via the intricate biochemical pathways of oxidative phosphorylation inside cells can be equated to the values measured by combusting these fuels in a bomb calorimeter.

What is the first step in delivering a brief intervention about weight?

The first step in delivering a brief intervention about weight is to weigh and measure the patient; also known as the ASK component. You should view this as a normal part of a routine consultation.

What is tier 3 obesity?

For patients with complex severe obesity, consider referral to a tier 3 specialist weight management service. Tier 3 services should be considered for patients with a BMI ≥35kg/m2, in the presence of diabetes and/or other significant co-morbidities; or patients with a BMI ≥40kg/m2 without the presence of diabetes and/or other significant co-morbidities; or patients with a BMI ≥30kg/m2 for whom tier 2 interventions have been unsuccessful. These services are delivered by a specialist multi-disciplinary team and offer a more individual service, usually incorporating psychological and dietetic input.