Despite the prevalence of overweight and weight-related disease in the United States, "most healthcare providers recoil when they think about counseling patients about obesity," according to Scott Kahan, M.D., medical director of the Strategies to Overcome and Prevent (STOP) Obesity Alliance.
A key reason physicians avoid the discussion, Kahan wrote in the Huffington Post, is inadequate training. "I had only one short lecture on obesity in medical school (just enough to learn to say: 'just eat less and exercise more!')," he wrote. "I can't recall any systematic training in the process of communication. And I certainly never learned about communication or behavioral medicine for obesity."
As a result, many of clinicians' attempts to talk with patients about losing weight quickly go awry, as illustrated by a video included with the Post. The dramatizations show how patients are likely to pull away, rather than engage, when healthcare providers communicate in a way that emits blame or shame, lectures or talks down, and gives authoritarian commands.
The good news is that resources exist to help physicians learn more productive ways to counsel their patients about reaching a healthy weight. A free toolkit from the STOP Obesity Alliance is just one example. The 22-page guide offers communication tips, advice for making office accommodations, steps for taking a team-based approach and links to further resources.
Importantly, the guide also notes that the reimbursement landscape for obesity counseling is shifting as well. Medicare now reimburses for obesity counseling in primary care, for example.