PSA to Doctors - How to Talk to Patients about Weight

Talking about weight is awkward. I feel awkward talking about it with my clients as a dietitian & nutritionist. Most times I don’t even bring it up.

If you’re a doctor, I know that you have the best of intentions. Perhaps many of you are already practicing weight inclusive care. For those who are less familiar with this space, let me share with you my experience as a dietitian.

Imagine starting a conversation with “Hey Jane, I noticed that your weight is in the overweight range, what have you been up to in terms of diet and exercise?” That kind of lead-in almost assumes that not enough has been done.

On the flip side, imagine starting a conversation with “Hey Jane, what healthy habits do you currently have? What helps you feel at your healthiest and happiest?” At this point, you get to hear your patient’s story and their lifestyle. If they feel that weight is a pertinent part of the conversation, they will bring it up naturally.

I’ve had patients w/ disordered eating/eating disorders come to me distraught after a doctor labeled them overweight. These women weren’t given a chance to talk about their victories and milestones with food and body. Aim to take the time to get to know your patient and acknowledge their progress. If they’re making active efforts in developing healthy habits, commend them, and leave the BMI talk on the sidelines. At the end of the day, BMI does not take into account metabolic biomarkers, genetics, muscle mass, and age.

Just remember, three out of four American women have disordered eating. ~30 million Americans have struggled with an eating disorder at some point over their lifetime. Think about a patient that has gone through the ends of the earth to heal their relationship w/ food. .Think about the patient that exercises daily and eats well, who just happens to have a larger body. People who are fit in larger bodies are significantly healthier than people who are unfit in smaller bodies.