Weight Loss

An OB-GYN’s Perspective On Having Tough Weight-Related Conversations

I was compensated by Med-IQ through an educational grant from Novo Nordisk Inc. to write about the realities of obesity as a chronic disease. All opinions are my own.

Talking about weight isn’t ever easy. It’s hard as a patient, and just as hard and as a healthcare provider. As a physician in a larger body, I have had uncomfortable, weight-related conversations with my healthcare providers and I have also had to facilitate these very sensitive, and often personal interactions with my patients. It’s a conversation that often does not typically end with everyone leaving feeling happy and accomplished.

 One of the main reasons why I feel there can be a disconnect during these conversations is because many times, there is an emphasis put on weight as the primary reason for health problems without stressing some of the other aspects that could be contributing to a health problem. This is one of the main reasons why I decided to partner with Med IQ. In the same way that I use my platform to empower women to make informed decisions about their health, I want to also make sure that I could help people feel confident speaking with their healthcare providers about weight. I want them to learn how to advocate for themselves when partnering with their provider to develop any treatment plans around weight.  

The first message that I have to anyone reading this is, especially if you are in a larger body, that you have to be ok with the body you are in right now. It’s also important to remember, you always have a choice as to whether you feel the need to lose weight for health purposes. I think conversely it’s important to me that those of us who are healthcare providers honor our patients’ choices. 

As much as you may feel that a patient may need to lose weight in addition to other parts of their treatment plan, honoring someone’s choices regarding how they feel about their body is essential. Whether or not your patient feels they need to or are ready to lose weight, is something that needs to be honored as well. Lastly, it is important to note that health is more than just numbers on the scale. There is so much more to being healthy. So, it is important to look at the whole person or patient when developing a treatment plan and not just a person’s weight. 

Now, let’s take a step back to highlight those of us who are patients and can relate to this experience. If you feel that weight loss would be beneficial to your health and is something that you are ready to do, this part of the article will be geared more to you. It is important to have an open dialogue with your healthcare provider about the weight that allows you to feel that you have a partner with your goals.

Something important to keep in mind that not enough people acknowledge is about the root of weight gain – it is not as simple as calories in and calories out. One primary factor that is not under our control is our genetics. If your mom is overweight or obese, you have a 55-85% chance of being obese. Outside of genetics, there are so many social factors that can contribute to weight gain. Access to nutrient-dense foods can be scarce if you live in certain areas of the country (urban areas vs. rural areas) as there may not be as many stores or restaurants that offer these options. If nutrient-dense options are available, that doesn’t mean they will be affordable for many of the people who live in those areas. Also, if you don’t have regular access to healthy foods or money, you may have increased stress levels and poor sleep quality in addition to a lack of nutrients, which also can increase your likelihood of gaining weight. 

If you layer on the stressors of the pandemic and the resultant challenges that it has brought to so many people, the increased stress can cause inflammation, which has also likely led to increased weight gain in many people. These factors must be acknowledged when looking into how to address weight and not calorie intake alone. 

It is important to have an open, judgment-free dialogue between all parties in a medical visit. The medical provider should first establish that a patient even wants to have the conversation. If the patient has decided that they would not like to engage in the conversation, as medical providers, we need to honor that. We can also let the patient know that when they are ready to have the conversation, we are there to have it with them.

Conversely, if a patient seems receptive to speaking about their weight, I ask you to keep what I said earlier in mind – calories in vs. calories out is not always the answer. It is important to acknowledge upfront that many factors contribute to a person’s size. Also acknowledging that weight is not the sole reason for a person’s medical problems is key. This ensures that you are treating the whole patient while providing the best possible care.

 I’d like to end with this – if you are someone in a larger body and decide that you would like to lose weight and would like help from your medical provider, don’t be afraid to have the conversation. You are not alone. There are so many different ways that your medical provider can help you achieve your goals. Not only can you get advice with nutrition and physical activity, but there may also be some medications and even surgical options that they can offer you to help get to your goal!

The key to success is developing a partnership based on trust.

Med-IQ is conducting an anonymous survey and would appreciate your input. The survey will take less than 10 minutes to complete. Survey responses are shared only in aggregate. 

Your responses to these survey questions will provide Med-IQ with important information about the challenges you have experienced when trying to lose and maintain weight and any strategies that you have used, which will help us develop future educational initiatives. 

Once you’ve completed the survey, you will have the option of providing your email address to be entered into a drawing administered by SOMA Strategies to win 1 of 6 $100 VISA gift cards. If you choose to enter, your email address will be used to randomly draw the winners and notify them of their prize.

Here’s the link!