NorthShore Physician Offers Guidance to Doctors on Talking About Obesity

Goutham Rao, M.D.

8/18/2011 – A NorthShore University HealthSystem (NorthShore) physician is the lead author of a new Scientific Statement from the American Heart Association (AHA) that offers specific recommendations about how to address obesity with patients in busy out-patient settings, which research shows physicians too often don’t do. The statement is published in the current edition of Circulation, Journal of the American Heart Association.  

Obesity is a significant public health issue in the United States but according to research, physicians and other healthcare professionals are poorly equipped to tackle the problem.

“The number one barrier to physicians discussing obesity with their patients, we learned, is they simply don’t know what to say and do,” said Goutham Rao, MD, Vice Chair of the Department of Family Medicine at NorthShore and lead author of the AHA statement, New and Emerging Weight Management Strategies for Busy Ambulatory Settings. “And even if they have the confidence to address an obese patient about their weight, they too often don’t have the skills to make an effective weight-loss plan.”

Rao and colleagues reviewed hundreds of medical reports and studies for the Scientific Statement, and came up with recommendations that they said would help physicians engage patients and bring about behavioral change. Their recommendations include: 

• When talking to patients about obesity, physicians should take an unhurried, non-judgmental approach. For example, they should use the term “weight” rather than “obese.”
• Physicians should develop a specific plan of action that engages the patient in the plan rather than offering vague recommendations about losing weight.
• An extra but important step is assessing readiness to change among patients.
• Central planning and training should be incorporated in a collaborative approach involving physicians, nurses and other caregivers when dealing with obese patients.

The Scientific Statement also advises using validated tools that already exist such as the Eating Pattern Questionnaire to assess behaviors that contribute to excess weight gain.

Data from the Centers for Disease Control and Prevention show that more than two-thirds of Americans are overweight or obese, but in a recent survey 35 percent of obese patients were never advised to lose weight by their physicians. Rao and colleagues say larger studies on this issue are needed involving a diverse set of overweight and obese patients, including research into technologically-based interventions.