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How to you tell someone they need to lose weight?
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You didn't specifically say what you do, so I have a few thoughts on this. I equate a medical professional that I don't have an expectation to see for follow-up care telling me to lose weight to my dental hygienist telling me to floss - I assume you say it to almost everyone. I also pay considerably less attention to someone I'm never going to see again than I do someone I'm going to have to go to for follow-up care (sorry, but it's true). And I don't want to hear about my weight every time I go in for issues that are completely unrelated... what zyxst said is 100% true in my case "It became the standard prescription: ear infection? sore throat? pneumonia? car accident? second degree burns? "lose weight".
If you only see patients once or twice, offer them some information to someone who can help if they want it. Keep those numbers handy. If you can made a referral, do it if they want one.
If you're in a position where you're working with the same patients over and over again, you can approach it like a previous commenter said and say "I noticed your BMI is XX, that puts you in/close to the overweight/obese category." Then, I would add this... "Combined with your medical history/family medical history, that puts you at an increased rate for x, y and z. Is there something I can do to help you with this?" - this approach makes it personal, and it's supportive.
If the answer is no, then follow up with "When you're ready, please come to me and I will (insert whatever you can or are willing to do for the patient)".
My GP brought up my weight every visit. It would be irresponsible as my doctor for her not to. But she brought it up, and she accepted that I was "working on it" even though we both knew I wasn't working on it that hard. When I was ready and willing to get help, we talked about my options and what I was doing. When I've done well, she acknowledges that I've done well and how I've done it and we talk about more options if I want them. But the most important thing she's ever done for me is that she didn't waste my time or hers talking about something I wasn't ready to deal with, she treated me like a person who deserved good medical care in spite of an issue I didn't want to work on and spent time working with me on the reason I was there. She's always been straight-forward with me and supportive.6 -
I work in the medical field and at least 50% of my patients are overweight if not obese. It is a crisis in the US and most of the Westernized countries. We counsel them on smoking and alcohol, but what about weight? What is your reaction to someone or a medical practitioner telling you to lose weight? Most of the responses I get are eye rolls (and I'm very delicate about how I address it), but what would cause someone to wake up and understand that its more than just aesthetics and more about health in general. The majority of the ailments I see can be directly correlated with being overweight or obese. Any thoughts? Any one who has had this happen and actually take the advice and be a success story? TIA
Ultimately it comes down to the patients willingness/want to change and them having the right tools to make the change. There seems to be a wide range of people on here and their desire to want this information thrown at them. Why not ask your patients before going on about it? "I notices that at your weight and height you fall in the morbidly obese category which increases your health risks. Would you be open to learning how we can change that?" If they say yes, explain the health risks, give them a plan, be blunt with them, etc. If they say no, just say that if they change their mind they can come to you for information. I wouldn't even bring it up at all if it is not related to what they are at the doctor's for. I dont need a weight lecture to fix my ear infection. Again, they need to decide if they want to lose weight, you can't decide for them.
When I decided to go see a nutritionist (on my own since the doctors were not very helpful), I was given a small booklet full of health, diet, and exercise information that was extremely helpful and was able to get me started. I wish that doctors had something like that available for patients that show interest in losing weight.2 -
When I see my dr, which is rare and never for 'weight issues', he quite often tells me I should lose weight - no matter what the scales say. If I wasn't healthy (cholesterol and BP are fine, no diabetes) I might believe him. But you know, 'advice' coming from someone who is battling the bulge isn't going to inspire me. The dr is about 40kgs overweight himself. Of course, I'm probably not likely to listen to a trim fit person either because I'll hear them being 'nasty'. The dr was really surprised when I told him at the last visit I'd lost 37 kgs, but had put some back on because I felt like crap at the lower weight. He wanted me to go back to feeling like that.
My best push to 'do something' was my BIL dying of a heart attack. He was younger than me and about 80kgs overweight. My best friend was also 'doing something' and he supported me. Life caught up with him and he isn't 'there' as much as before. Without that support, the weight is creeping back on. I know it is, and I don't like it, but..no drive to change anything again.1 -
OP: I've been seeing the same doctor since 1992. He has always told me the same thing: stop smoking, lose weight, stop drinking, eat better, get some exercise. Ironically, my blood numbers have always been well within normal ranges. It took me most of the past 25 years to make the necessary changes, but as of 2016, I am a non-smoker, I've lost a total of 66 pounds from my heaviest weight, I only drink occasionally and moderately when I do, I follow a Paleo diet, generally, and I do 2 strength, 2 cardio and 1 stretch session every week.
It takes what it takes. So don't sugar-coat it. Just put it out there.2 -
I work in the medical field and at least 50% of my patients are overweight if not obese. It is a crisis in the US and most of the Westernized countries. We counsel them on smoking and alcohol, but what about weight? What is your reaction to someone or a medical practitioner telling you to lose weight? Most of the responses I get are eye rolls (and I'm very delicate about how I address it), but what would cause someone to wake up and understand that its more than just aesthetics and more about health in general. The majority of the ailments I see can be directly correlated with being overweight or obese. Any thoughts? Any one who has had this happen and actually take the advice and be a success story? TIA
If it is relevant to the medical condition you are treating and you have helpful advice then you should bring it up.
"Bob, I see your weight is higher than the healthy range for your height. Excess weight makes your specific health condition worse. Losing weight can improve your condition, reduce your need for medication, etc. Weight loss is about calories. Using this calculator, XYZ is the amount of calories you would need to consume daily to maintain your current weight if you are sedentary. Reducing your calorie intake by 250-1,000 calories daily would result in weight loss. Would you like to talk more about a healthy weight loss plan for you or a referral to a dietician to help you figure out a plan?"
If it is not relevant to what you are treating or you don't have time to say anything other than "You weigh too much. Lose weight." then don't bring it up.
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What does "in the medical field mean"? Are you a doctor? I don't understand why a doctor would need to ask people on a forum how to tell people to lose weight, that's your job.1
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DrifterBear wrote: »What does "in the medical field mean"? Are you a doctor? I don't understand why a doctor would need to ask people on a forum how to tell people to lose weight, that's your job.
I don't know, I've met a lot of doctors who could use a few lessons on how to speak to their patients. Listening would be a good skill for some as well.4 -
DrifterBear wrote: »What does "in the medical field mean"? Are you a doctor? I don't understand why a doctor would need to ask people on a forum how to tell people to lose weight, that's your job.
Let's call it continuing education. I'm a PA and no we (as well as MDs/DOs/NPs) are taught minimal information on weight loss let alone how to counsel someone. Can someone ask a question to see how it may have encouraged others to change? Just trying to be a better practitioner.6 -
Let's call it continuing education. I'm a PA and no we (as well as MDs/DOs/NPs) are taught minimal information on weight loss let alone how to counsel someone. Can someone ask a question to see how it may have encouraged others to change? Just trying to be a better practitioner.
I heart you, Internet Stranger, for this right here. I've had some amazing Dr's and PA's over the years and appreciate that you're trying.
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DrifterBear wrote: »What does "in the medical field mean"? Are you a doctor? I don't understand why a doctor would need to ask people on a forum how to tell people to lose weight, that's your job.
Let's call it continuing education. I'm a PA and no we (as well as MDs/DOs/NPs) are taught minimal information on weight loss let alone how to counsel someone. Can someone ask a question to see how it may have encouraged others to change? Just trying to be a better practitioner.
Just my experience but my current GP focuses more on encouraging me to get some exercise and actually listens to my issues and is able to help me come up with some alternative ideas. She also listens when I tell her the problems I'm having implementing certain things. I've had providers in the past that see the extra weight and my care with them begins and ends with that. I work for a teaching hospital so that is where some of my experience comes from. Then there are the ones that talk to each other over you, like you're a biology lesson. Not saying you do that, though.
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I remember at my pediatrician to school shots at age 5 the dr saying you need to loose 10 lbs your not in normal range. I remember leaving the office and going to McDonald's. What I don't remember is the Dr helping my overweight mom help me! Skip ahead to 19 and my first pregnancy hubby and I went to obgyn for sonogram and Dr said no heart beat and as long as your this fat you will never had children....Skip ahead many years (no children put on another 100 lbs) new Dr started back in November. Dr says I'm not doing this to shame you I want to help you and you already know your overweight with high blood pressure, diabetes, and many other medical issues that can be helped by weight loss. He also said I'd like you to see a dietician so you can learn about portions and carbs and fats and proteins and how they affect your body.....Now it took me a bit to become serious I thought it was to late to reverse damage.
Help those you break the news to. We know we are fat and I'm not saying everyone will accept the help but those that are ready most likely will! I really didn't understand portions and such but I'm learning! Just be ready to help and offer it!
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At a minimum, maybe having pamphlets for MyPlate available? I know they have quite a few printables on their webpage. Something generic like this might prompt discussion:https://choosemyplate-prod.azureedge.net/sites/default/files/printablematerials/mini_poster.pdf0
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I work in the medical field and at least 50% of my patients are overweight if not obese. It is a crisis in the US and most of the Westernized countries. We counsel them on smoking and alcohol, but what about weight? What is your reaction to someone or a medical practitioner telling you to lose weight? Most of the responses I get are eye rolls (and I'm very delicate about how I address it), but what would cause someone to wake up and understand that its more than just aesthetics and more about health in general. The majority of the ailments I see can be directly correlated with being overweight or obese. Any thoughts? Any one who has had this happen and actually take the advice and be a success story? TIA
I'm in Canada. And I've developed some health issues and have other ones in my family that were, if not caused by obesity, definitely not helped by it. My father and younger sister have both had bariatric surgery. When my parents visited me in September, my dad urged me to get onto that list, too. I refused. Well, I blew him off, telling him I'd think about it.
The thing is, at that point, I had somehow contracted cellulitus. While that was being treated, I also developed lymphedema, which led to having nurses come daily to change the dressings, 7 courses of antibiotics (not counting the IV I got in the emergency room when I was diagnosed with cellulitus). (2 courses to treat the cellulitus and because the lymphedema improved slightly on the first course, but didn't respond as well to the second. At that point, they cultured the wound and put me on one course of a different antibiotic. That didn't work and they still didn't have the lab results back, so they tried a third one. That one didn't work either, but by then they had the results and it took 3 courses of the right antibiotic to finally get the wound to heal).
Meanwhile, I was referred to a vascular surgeon, who told me that my leg veins were refluxed. And that while compression stockings are the main treatment, the best thing I could do was relieve some of the pressure on my lower body by losing weight; something my doctor agreed with. A prior GP had told me to join Weight Watchers. Thing is, while I did at the time, lost weight, and gained it all back plus more, at this point I'm unemployed. I told my doctor that I couldn't afford WW and he told me the obvious: that it's possible to lose weight without them. I found MFP when I was Googling looking for an online calorie counter and joined up.
I have to say that I'm stubborn and laissez-faire enough that, had I been told to lose weight when I didn't have health issues, I probably wouldn't have listened. I'm stubborn and, while I'm usually smart, I can be stupid about certain things. Like my weight, sigh. But I did need to hear that my weight was making an already bad situation worse and that I could do something about it.0 -
DrifterBear wrote: »What does "in the medical field mean"? Are you a doctor? I don't understand why a doctor would need to ask people on a forum how to tell people to lose weight, that's your job.
This was my question. Most replies are assuming a scenario involving their doctor. Would a person accept advice as readily from a nurse or some other professional? I like the point made by @HotAshMess . I think it would be best received by someone you have an ongoing relationship with.2 -
Most people already know they need to lose weight. But I understand working in the medical field it's your job to tell them.
Just lay down the facts, but don't be rude. I think it helps to ask questions about their health including diet and activity so you can better tell them what they can do to get healthy.
I remember being told as a 13 year old kid "you need to stop drinking so much soda, you're 50 lbs overweight"
I never had soda growing up and he came off very cold. I simply closed up and didn't listen to a word he said because he didn't even know why I was overnight and was just blabbing.
But I KNEW I needed to lose weight. I just didn't know how to at the time. Coming from a family in the south where almost everyone was overweight I had no clue about nutrition.
Give them advice on how to lose the weight and tell them the health risks. They'll lose the weight and get healthy when they're ready and in their own time. Nothing you can do about that.
I didn't listen to a word he said if I'm being honest. I lost weight a few years later when I was sick of being fat.2 -
DrifterBear wrote: »What does "in the medical field mean"? Are you a doctor? I don't understand why a doctor would need to ask people on a forum how to tell people to lose weight, that's your job.
Let's call it continuing education. I'm a PA and no we (as well as MDs/DOs/NPs) are taught minimal information on weight loss let alone how to counsel someone. Can someone ask a question to see how it may have encouraged others to change? Just trying to be a better practitioner.
Got it. First, I'd say it's the same as any other health issue that requires some change from the patient. Quitting smoking, overweight, alcohol abuse, high BP, cholesterol, etc. You should bring it up, even if you do every time and nothing changes. Tell them the condition and the implications and be prepared to offer support for how they go about implementing the change. Be straightforward but compassionate. Explain this is the indicator you're overweight (weight, BMI, etc), these are the implications of the condition, and here's what you can do about it when you're ready.
Second, even though you're a doctor, you probably know these things require a great deal of desire from the individual. If they don't want to change, all you can do is continue pointing out the condition and suggesting they make some changes. They may be hearing it from friends and family, and it's almost certainly not news to them either. You however are uniquely suited to offer solutions that may benefit them when and if THEY become interested in making a change.0 -
I had been in to see our local ARNP several times for gastrointestinal & joint issues. Received referrals for expensive testing and prescriptions for symptoms. After having lost 50+ lbs, I was there for something else and mentioned to her that the weight loss had completely cleared up many of my issues. She was so excited and said something to the effect of, "I figured that would help a lot!" Well, she never mentioned it to me!1
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I don't know, maybe because their dr / nurse is overweight/obese too? Most doctors and nurses I've come across are overweight/obese themselves. It's rare I see a trim/fit doctor.
For me, bad numbers would shame me into making changes. A random (one-time) high bp reading freaked me out enough to cut back on caffeine and sodium.0 -
You can't make everyone happy, but an empowering message would be nice- "You know, it's completely within your power to improve/reverse this situation and improve the quality of your life. Would you like some guidance on how to get started?" However, a problem we often see on MFP is that doctors themselves, with their limited education in diet & nutrition, don't always give very good advice when it comes to weight loss. For example, giving blanket advice to eat 1200 calories and cut out carbs.DrifterBear wrote: »What does "in the medical field mean"? Are you a doctor? I don't understand why a doctor would need to ask people on a forum how to tell people to lose weight, that's your job.
Let's call it continuing education. I'm a PA and no we (as well as MDs/DOs/NPs) are taught minimal information on weight loss let alone how to counsel someone. Can someone ask a question to see how it may have encouraged others to change? Just trying to be a better practitioner.
I do think people have to be ready before any advice or encouragement would do any good, but I find it very encouraging that you are looking for better ways to connect with and benefit your patients, OP.
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DrifterBear wrote: »What does "in the medical field mean"? Are you a doctor? I don't understand why a doctor would need to ask people on a forum how to tell people to lose weight, that's your job.
Let's call it continuing education. I'm a PA and no we (as well as MDs/DOs/NPs) are taught minimal information on weight loss let alone how to counsel someone. Can someone ask a question to see how it may have encouraged others to change? Just trying to be a better practitioner.
As a PA, I would consider it a job requirement to mention potential medical issues to the patient, even if not the reason for the visit. Suppose if someone came to see you for strep throat and during the exam you see something that appears to be the start of skin cancer, wouldn't you suggest they get it looked at? Same for weight issues.
I would think if the person comes to the practice on a regular basis, their weights from the previous visits would be in their charts. Might change the message depending on any changes you see.
You are a valued and respected professional, people should at least take your advice into consideration..4 -
I got told by someone that I highly respect what a fat, disgusting, borderline subhuman piece of *kitten* I had been for my entire life. That was at 265.
I haven't weighed over 190 in years. So yeah, it worked. Probably not the best way for a doctor to put it though.5 -
I had a doctor tell me at the tinder age of 14 that no matter what I would never be skinny so I was like what is the point. Then he gave me a diet plan that was basically the cabbage soup diet. What 14 year old wants to do that? Ahhhh 1996.1
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My last doctor was a bit of an *kitten* about it. Didn't matter what I was seeing him for, it was weight related (it wasn't). I knew what issues came from my weight and which ones didn't and it just got frikken annoying.
My response was not the best one. I stopped seeing him and now just go to a clinic if something is bothering me. Have not had to do that for years. And, I'm not going to see a doctor again until I am no longer obese. I understand it is not the right attitude, but I've become stubborn about it and am actually doing something to not be obese.
I'll go find a new doctor (actually not easy to do where I am in Canada) when I know they will not be focused on the obesity and can actually act like a doctor.
Besides, this last guy kept sending me to the health food store for homeopathic *kitten*.5 -
I understand the responses about not wanting weight brought up as an issue at every single doctor's visit, and basically agree. If you are sick with strep throat and feel lousy, not the time for a heart to heart about your weight, IMO. But don't some people only see the doctor when they're sick or have an emergency? What then?3
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I understand the responses about not wanting weight brought up as an issue at every single doctor's visit, and basically agree. If you are sick with strep throat and feel lousy, not the time for a heart to heart about your weight, IMO. But don't some people only see the doctor when they're sick or have an emergency? What then?
It's one thing for the doctor to talk about your weight in a general sense, but when it has nothing to do with the ailment you are there for, don't try to suggest it does. Make it 2 separate conversations. But don't make it sound like you are dismissing why the patient has come in just because they need to lose weight.
I found, that if I had an issue and went to the clinic, that is what they focused on. But if I went to the doctor with an earache, he ignored the earache and just talked about the weight. And I left with an earache and some *kitten* prescription for something from the health food store that I just tossed in the trash.0 -
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That being said, I did roll my eyes at the MA who tried to fat shame me when I had high blood pressure at an urgent care clinic while waiting to be seen for a sinus infection. She gave me a snide, "Is your blood pressure always this high?" when it was barely over the normal range...
Maybe fat shaming was not the intent of the question. I don't think most doctors are trying to be mean or disrespectful. Maybe she just really wanted to know if your blood pressure was always that high vs. elevated by an infection? High blood pressure slowly destroys your internal organs over time. Cultivating high BP is one of the worst things you can do to yourself. She wouldn't be doing her job if she didn't point out a possible concern. I bet these people get eye rolls and bad attitude all day long from their patients, and I bet they hate bringing up these "sensitive" weight related topics for just that reason...
And I don't think it should matter whether it's your primary care doctor mentioning risk factors or if you are being seen by an urgent care doctor. The problem is still the problem. Some people don't go to doctors regularly. An urgent care doctor might be the one doctor they see in years, and the one person who could help bring attention to a serious issue.
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My Dr, apparently was obese at one time, since she has an article on the wall from a mag with her picture in it talking about some sort of band surgery. She also has info & phone number to some kind of weight loss help. The most she ever focused on, no matter what was wrong with me, was my weight & A1C labs. I was very glad to see her again after loosing 20 lbs & my A1C was lower too. Next time i see her I'm planing to be 40lbs less2
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The only advice I could have is to be honest, do not sound judgmental, give them the tools to help themselves. Let them know you are there to help them not to judge them. You need to be honest with them, but it depends if they are ready to accept this advice or not?0
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I recognize that, as a doctor or nurse, you know all to well that overweight people risk having all sorts of weight-related problems, including musculoskeletal issues when they try to exercise. So, from that standpoint, how could a provided not bring it up in an exam?
Still, IMHO, the message depends more on the listener than the messenger. Although I expect that some docs have really muffed the delivery in some cases, if the patient is ready to hear it, it could change their life.
Maybe they're just playing the numbers to keep bringing it up.0 -
It's hard. I am a vet and a good portion of my patients are obese as well. Most of the time I think a lot of it goes in one ear and out the other. I try to tell them it costs $300 for a bottle of insulin for their 20 lb cat when it gets Diabetes. The cat weights 22 lbs the next time I see it. You have to say it. You have to say what it contributes to, what they might have now that may diminish with it and let them do what they will. Nothing will change no matter what you say if they don't want to hear it.3
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