How to Talk to your Primary Care Provider (PCP) about your Weight

If you’re like my patients, most likely the Covid-19 pandemic has made you re-evaluate your health habits and even inspired you to better manage your weight.

If you’re serious about getting help to do so, a good place to begin is by reaching out to your PCP.

You see weight management really is a team sport and since your PCP knows your medical history, risk factors, lifestyle behaviors and lab results, he or she can help direct you toward a plan that takes these into consideration.

But bringing up the topic of weight isn’t always easy and may even make you feel uncomfortable.

Here are some tips to help smooth the way:

1 – Before your visit, think about what may be missing to help you better manage your weight

Though one of the first questions I ask all of my new patients is “how can I help you?”, I usually have to ask probing questions to find out more specifically the type of help my patients need.

Beforehand, I encourage you to be more thoughtful about the specific areas you may need help with, such as:

-Knowing what to eat and meal planning

-How to control your appetite

-Ways to boost motivation and accountability

-Types of exercises to do that are safe

Help with stress eating, a low mood or anxiety that keep getting in the way

2-During the visit, ask your PCP how excess weight is affecting your medical condition and how losing weight can help

More specifically, you can ask the following:

-Do any of my medications cause weight gain? And if so, are there other medications to try instead?

-Which of my medical problems and lab tests will get better as I lose weight?

-How much weight do I need to lose to start seeing some health benefits?

-When beginning an exercise program, are there any precautions I should be taking?

-What kind of diet plan should I be following?

-Are there any recommended food, fitness or coping apps you think I should try?

-Would I benefit from taking an anti-obesity medication or considering bariatric surgery?

-Can you make referrals if I need more help with diet, exercise or health behaviors? Referral to a registered dietitian nutritionist, a certified personal trainer or a health psychologist may give you the coaching and direction you need to be successful.

My patients are often surprised to know that losing just 5-10% of their body weight can lead to meaningful health benefits in terms of lowering blood pressure, blood sugar and improving cholesterol and other blood fats, improving sleep, reducing knee pain and heartburn, and helping you to generally feel better.

3 –Be aware of weight bias

It is known that people affected by excess weight or obesity can feel stigmatized in healthcare settings.

Experiencing weight bias when communicating with your PCP should not be overlooked as it can lead to depression, anxiety and feeling less motivated to adopt healthy lifestyle changes.

Just like diabetes or high blood pressure, obesity is a disease that requires a thoughtful and empathetic approach on the part of health care providers.

If you feel your PCP is blaming you for your weight or not treating you with respect, let your PCP know that this is not okay.

You can also tell your PCP that you know that managing weight is complex and due to more than just willpower and that you are asking for professional help.

If your PCP is not able to give you the help you need, you can always try to find a different PCP who may have more interest in and experience providing evidence-based weight management therapies.

PCP’s vary in their ability to supervise you through a weight management program.

Whereas some PCP’s may partner with you and give you healthy lifestyle strategies and diet tips to follow, others may periodically check your weight and labs while encouraging you to follow a commercial or self-help weight management program.

The key is to find a PCP who can support your healthy weight management journey and who you feel comfortable with.

Another available option is to make an appointment with an Obesity Medicine Physician Specialist, which is a health care professional with specialized training in obesity management.

To find a specialist in your area, you can use the Find a Physician Tool on the American Board of Obesity Medicine (ABOM) Website at www.abom.org.  ABOM Diplomates typically offer a wide range of treatment options including lifestyle support and medication if needed.

Stay safe and be well!

RK

Robert Kushner, MD

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