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Ask – Raising the topic of weight

Learn how to raise the topic of weight.
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SPEAKER: It is important to remember that everyone brings something different to the clinical encounter. If you were the patient, think about what you might think and how you might feel if your clinician brought up the topic of your weight, and mention weight loss as an option for treatment.
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Consider the following patient scenarios. So patient scenario number one. Imagine yourself to be a person who feels resigned to being overweight. So imagine that you’ve struggled with weight all of your life, even back when you were a child. And you’ve tried multiple diets and multiple interventions in the past, with no long-term success. You also have little confidence that you can do anything to lose weight. What might you think and feel during the consultation if the clinician started talking to you about your weight?
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Take a bit of time now to reflect on what sort of thoughts and feelings you might have if you were that patient who feels resigned to being overweight.
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So perhaps you would have some thoughts like this. The clinician doesn’t understand how hard it is for me. Why bother, I can’t lose weight. You might even think of yourself as a failure.
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In terms of your feelings, maybe you would feel hopeless, despondent, or even embarrassed.
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Let’s consider another scenario. In this scenario, you’re patient who is maybe quite comfortable in their own skin. So imagine this time you’ve still struggled with weight all of your life, but you’ve worked really hard, to a point where you have a positive body image, and you’re now really quite confident in yourself. In this scenario what might you think and feel during the consultation if the clinician started talking to you about your weight? Take this time now to reflect on the sorts of thoughts and feelings that you might have as somebody who is above a healthy weight, but who is comfortable in their own skin.
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Perhaps you’d have thoughts like why are you bringing this up. I don’t want to try to lose weight. It might even put you off coming back to see the clinician again in the future.
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In terms of your feelings, maybe you would feel angry or frustrated.
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Now let’s consider a third scenario. And this is somebody who has experienced some recent success with weight loss. So imagine you were a healthy weight for most of your life, but you slowly gained weight over the past few years. Just recently though, you managed to lose two kilogrammes over three months through diet change and increased physical activity. In this scenario, what might you think and feel during the consultation, if the clinician started talking about weight.
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Again, just take a little bit of time to reflect. Remembering this time you’ve had some recent success with your weight loss. How might you think and feel when your clinician asks you about weight?
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You might think thoughts like, yes I get it, I can keep going and lose some more weight. That’s great, losing more weight will help my symptoms more, too .
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Perhaps you would feel hopeful, and motivated, and confident that this is something you’re going to be able to achieve.
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And so what it’s important to remember is that everybody brings different life and weight experiences to a consultation. You’ve taken some time to reflect on how patients may feel in your clinical setting, and you understand that this is different for different people, and is impacted by individual people’s experiences and perceptions of their own weight. Reflection is important for us to be able to act with empathy in our clinical roles.

The 5 minute video provides three patient scenarios where the clinician raises the issue of their weight. It asks you to reflect on how you might think and feel if you were the patient in each scenario.

Asking the patient for permission to discuss weight is vital given that weight is an extremely sensitive and complex topic for most people.

Reflect on the questions below:

When do you bring up the topic of weight with your patients? How do you bring up the topic? What do you say? What sort of reactions do you get from your patients when you mention weight?

Click on the ‘Add a comment’ link below to share your answers. Once you’re happy with your contribution, click on the ‘Mark as Complete’ button to check the Step off.

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EduWeight: Weight Management for Adult Patients with Chronic Disease

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