Six tips for a fruitful conversation.
By Louise Chang, MD
WebMD Weight Loss Clinic - Expert Column
Each year, plenty of us make New Year's resolutions to lose weight and improve our health. And we all know that before jumping into a new weight loss program, it's wise to discuss these plans with a doctor.
But just how do you go about starting such a conversation?
Some Weight Loss Clinic members have complained that their doctors seemed too busy or not interested when they tried to discuss their diets. There are many possible reasons for this, including the doctors' level of comfort with discussing the topic, their communication abilities, and time constraints.
"Obesity is pretty complicated for doctors to treat, because it involves behavior, medication, as well as managing medical conditions that come with obesity, like type 2 diabetes, hypertension, and high cholesterol," notes researcher Gary D. Foster, PhD, clinical director of the Weight and Eating Disorders Program at the University of Pennsylvania.
Indeed, research shows that doctors don't always broach the topic with their patients. In a study published in the journal Preventive Medicine, researchers looked at more than 600 visits to family practice offices where 68% of the adult patients were overweight or obese. They found that only 11% of the overweight or obese patients received weight loss counseling during these visits.
And just like the general population, some doctors may harbor biases toward the overweight and obese. In a study led by Marlene Schwartz, PhD, co-director of the Center for Eating and Weight Disorders at Yale University, researchers gave a test to health professionals attending a national meeting about obesity. The results indicated that some weight bias was present, although Schwartz noted that health professionals were not as biased as the general public.
So where does that leave the patient hoping to lose weight?
As with any health issue, it's a great idea to be proactive -- and doctors appreciate patients who are genuinely interested in their own health.
Your annual checkup is a great time to address concerns about weight with your doctor. But there's nothing wrong with scheduling an appointment specifically to discuss weight and diet issues.
Before your meeting, consider doing some homework to prepare. Here are some things to think about:
1. Have goals: How much do you want to lose, and in how much time?
2. Be realistic about your goals and limitations. An acceptable goal is losing 5%-10% of your current weight. Anything more than that may be unrealistic, or even unhealthy. Your doctor can help you come up with a realistic plan that can give good long-term results.
3. Don't be shy -- initiate the discussion. Some doctors may not feel comfortable broaching the topic of weight, fearing that they'll hurt the patients' feelings. Perhaps during a previous visit with you or another patient, the topic was an awkward one. Doctors also may avoid the topic because they don't feel experienced enough in counseling weight management.
4. Don't be intimidated by numbers, or get caught up in labels. Pounds, BMI, and waist circumference, and words like "overweight" and "obesity," will come up in any discussion about weight.
5. Talk about diet and exercise. Long-term success usually requires a combination of lifestyle changes. Think about what you can do to increase your activity level, and share your ideas during your office visit. If you have a pedometer, keep a record of your steps in a typical day as a reference point to improve upon. Have your doctor write out a "prescription" for exercise. This plan will be added to your medical chart and monitored during follow-up visits.
6. Bring in a food diary. This might cover two or three days, and should include everything you consumed during those days -- which foods and drinks, and how much of each. Keeping a diary may give you some immediate ideas on where to "cut the fat," and the information will be useful for your doctor as well. A written diary is more specific and accurate than any discussion of eating habits will be. Have your physician write down dietary suggestions or give you a handout on what you should be eating. He or she may also refer you to a nutritionist or dietitian.
No time to prepare for your talk with your doctor? Then at least be mentally ready for some honest talk.
Remember that managing your weight will help to improve your overall health. Give yourself time to accomplish your goals, and enlist the support of others -- be they family, friends, or a support group such as the Weight Loss Clinic's message board community.
Losing excess pounds in a healthful way can help you lower blood pressure, improve cholesterol levels, and better manage your blood sugar if you have diabetes. It can relieve the pressure of excess weight on your joints if you have arthritis. And the effect is usually cyclical: the better you feel, the more motivated you become to live healthier.
Originally published December 30, 2005.
Medically updated January 6, 2007.
SOURCES: Preventive Medicine, June 2004. Obesity Research, September 2003. WebMD Medical News: "Even Doctors Have Obesity Prejudice." WebMD Medical News: "Doctors Don't Address Patients' Obesity."
Louise Chang, MD, is part of the WebMD medical editing team. Her opinions and conclusions are her own.
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