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The authors of a recent article outlined strategies physicians can use to develop a patient-centered approach to starting weight management conversations.

Obesity remains a major US public health concern, with projected estimates that nearly half of adults will meet the criteria for obesity by 2030. Developments in obesity research, coupled with shifts in the perception of obesity from the medical community and public, have led to obesity being recognized as a complex chronic condition. Yet, many patients living with obesity still face shame in their interactions, which can delay treatment.

In a recent “Points to Remember” article, Sharon Anderson, MD, and colleagues outlined strategies for clinicians to develop a patient-centered approach to weight management discussions. This approach aims to foster an open dialogue and reduce weight stigma and biases surrounding obesity.

The recommendations published in the Methodist DeBakey Cardiovascular Journal include the following:

• Create a welcoming office environment: Having chairs, exam tables, gowns, and other medical equipment that accommodate patients with larger builds and higher weights shows that patient concerns will be addressed without shame or bias.
• Use people-first language: Use phrases such as “patient with obesity” or “person affected by obesity” rather than “obese patient,” as this will decrease weight stigma and reinforce a focus on patient health.
• Ask permission to discuss weight management: Asking patients whether they are open to discussing their weight allows them to explore the topic instead of receiving unsolicited and unexpected advice.
• Assess readiness for change: Using motivational interviewing techniques, clinicians can better understand patients’ personal goals and address potential barriers to weight loss plans.
• Don’t overemphasize BMI or weight: Current research advises that patients need individualized assessments of how obesity impacts their health. Clinicians should promote a holistic lifestyle approach that emphasizes cardiovascular fitness and nutrition rather than BMI or weight.
• Avoid stigmatizing terms and phrases: The Obesity Medicine Association encourages clinicians to use terms such as “unhealthy weight,” “overweight,” and “affected by obesity.” Terms that are discouraged include “morbidly obese,” “obese,” “fat,” and “large size.”
• Use shared decision-making for treatment plans: Collaborating with patients to navigate management approaches and develop realistic and effective goals can improve outcomes.
• Continue the discussion: Ongoing support and follow-up are key for long-term success as patients follow their treatment plans and stay connected to their goals.