Starting a Conversation with Your Doctor About Weight Loss
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Maybe you’ve struggled to lose weight and keep it off, and you know how dangerous extra pounds can be to your health. Still, many of us who have access to professional healthcare have a hard time talking about weight loss with our doctors.
Deepa Sannidhi, MD, an obesity and lifestyle medicine physician and director of the Supervised Lifestyle and Integrative Medicine Program at UC San Diego Health, sat down with Everyday Health at the 2023 American College of Lifestyle Medicine Conference in Denver to share tips on how to start the conversation.
Everyday Health: In a recent survey of over 3,000 respondents that Everyday Health conducted (which is outlined in our Weight Loss Reframed Report) we found that while 6 in 10 healthcare practitioners have talked with their patients about losing weight, only half of patients have asked their provider for help with weight loss. Why do you think so many patients are reluctant to ask their doctor for help with their weight?
Deepa Sannidhi, MD: They actually feel somewhat frustrated because up until recently there really haven’t been as many very effective treatments for weight loss, but also I think there are not as many medical professionals trained on how to speak about weight with patients, and how to speak about lifestyle with patients. And then the cherry on the cake is a lot of providers across the board don’t really know how to speak about weight and lifestyle in a way that’s not stigmatizing for patients.
Patients with excess weight will often know that their weight is not something that is acceptable to society or to them. There’s a book I give to my patients frequently called The Body Is Not an Apology. What a powerful idea. But for people with excess weight, they feel like their body is an apology all the time. So sometimes that feeling gets reinforced, and why would you want that?
EH: Is this a missed opportunity for patients if they’re not talking to their doctor?
DS: I think it’s helpful to talk to a healthcare practitioner that is competent in addressing weight. When the healthcare practitioner is not necessarily trained, they can actually do some harm by providing incorrect advice. There’s a lot in the media about how to treat excess weight that is not necessarily correct, and so if you have not received the proper training on how to treat obesity and excess weight, then you may be doing additional harm.
EH: Twenty-three percent of people we surveyed said they avoided going to the doctor because they did not want to be weighed, or they asked not to be weighed during their visit. What would you tell people feeling this way?
DS: You can talk with the staff about whether or not you want to see your weight, and that is a perfectly okay thing to do.
The relationship with the scale is one that is challenging — it helps to know that the number on the scale is a number and it’s not a judgment on your willpower, your character, and whether or not you are committed to taking care of yourself and being acceptable to society.
It’s hard to get to that place of self-acceptance, so it’s okay to not look at your weight when you’re at the office. There’s a pretty big overlap with people who have obesity and people who are experiencing some level of disordered eating or disordered relationship with their body, so it’s okay to take your time to start looking at the scale and start building a positive relationship with the scale.
That goes to an overall concept that I try to drive home with my patients, that taking care of your lifestyle and your weight in general should be about taking care of yourself, and not for being different for the sake of society. When you can have a better relationship with the journey, then you are focused on taking care of yourself, rather than addressing an extrinsic goal like looking better for others. It becomes about nurturing yourself.
RELATED: Everyday Health’s Weight Loss and Special Report: Weight Loss Reframed
EH: One in five people we surveyed said they’ve experienced shame, stigma, or discrimination from their healthcare professional. What advice would you give to any patients who come across this?
DS: One obesity activist suggests responding to discrimination by asking, “Would you say that to a slender person?”
Another idea is to talk about how you’ve already lost a significant amount of weight and you feel there may be other issues going on and you would like to have those things addressed.
If you have arthritis, that could be related to your weight, but there are other things that can cause arthritis, and it’s important for people to not put their blinders on. If you have an issue with abdominal pain and it seems like it’s related to acid reflux or IBS, it’s always possible that your weight could be playing a role, but there are other things that could cause that. So it’s important to push your doctor to continue to look at what else might be causing those things.
EH: Why do we need to talk to a healthcare professional versus just finding weight loss resources independently?
DS: The reality is if you go to a generic weight loss program, they’re going to give you a formula: If you do this for three months then you will lose weight and this is the answer. However, we now believe obesity is a disease, and this is an evidence-informed decision that the medical community has taken, because the data support that obesity is a condition that affects every single system in the body.
Research supports that you really do need more than just advice and initiative on the part of the patient to address it often. With this in mind, we have to understand that when people are struggling with obesity, it’s a lifelong journey and we have to take care of them across the lifespan.
EH: Let’s say someone has tried the fad diets or the commercial diet plans, and they’re ready to try a different route: working with their doctor to lose weight. How can they start that conversation?
DS: Ask them, is there something that can help me? Watch for how supportive your physician is and that will tell you if they’re the right person to help you.
EH: Is all this an argument for seeing an obesity specialist?
DS: There are a lot of obesity medicine specialists out there, so it is an argument to be seen by an obesity medicine specialist. However, there are many primary care physicians who are passionate about obesity and have gone out of their way to get trained in how to address excess weight, and there are many primary care physicians who are obesity medicine certified. If you go on to the American Board of Obesity Medicine you’ll be able to search for a physician, and even better, if you can find somebody who is certified in obesity medicine and lifestyle medicine, they can take care of the whole picture for you.
Everyday Health‘s Weight Loss Reframed Survey queried 3,144 Americans nationwide ages 18 and older who had tried losing weight in the previous six months. The study was fielded between July 10 and August 18, 2023, across demographic groups, genders, and health conditions. Survey recruitment took place via an online portal, in app, and via email. The margin of error for the sample size of 3,144 is +/-1.7 percent at a 95 percent confidence level.
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