How to Talk About Weight Without Stigma
As clinicians, addressing weight with patients is often necessary but can be met with challenges. A stigmatizing approach to weight can harm patient relationships, increase feelings of shame, and lead to worse health outcomes. Instead, a weight-neutral, compassionate framework fosters empowerment and supports patients in achieving their health goals.
Here are 3 strategies to having impactful, respectful conversations about a patient and their weight.
- Build Trust Through Empathy and Respect
Patients are more likely to engage in meaningful health discussions when they feel understood and respected. Empathy helps to build rapport, creating a foundation for effective communication.
Key Strategies
Ask for Permission: Start the conversation by seeking consent, such as, “Would you feel comfortable discussing how your weight may be impacting your health?” This respects the patient’s autonomy and ensures they feel in control of the discussion.
Avoid Judgmental Language: Replace terms like “obese” or “overweight” with neutral phrases like “weight-related health concerns.”
Use motivational interviewing: Employ open-ended questions to explore patient motivations and align the conversation with their personal goals. Example questions:
- “What would you like to focus on improving about your health?”
- “What changes feel manageable for you right now?”
- Focus on Health Behaviors, Not Just Weight
Shifting the focus from numbers on the scale to overall health behaviors can foster more productive conversations. Discuss improvements like better energy levels, sleep quality, or management of conditions like diabetes or hypertension. This weight-neutral approach can reduce stigma and improve adherence to health plans.
- Promote a Holistic Approach
Encourage patients to adopt a holistic perspective on health that integrates physical, emotional, and social well-being. Address factors beyond weight by highlighting the importance of stress management, sleep hygiene, and fostering social connections. This broader approach helps patients recognize that health is influenced by various interconnected elements, not just body weight.
Ask open-ended questions to gain insight into these areas, such as:
- “How has your sleep been lately?”
- “What’s been your biggest source of stress recently?”
- “Are there any changes in your daily routine or social life that have impacted your health?”
These types of inquiries provide a fuller picture of the patient’s health, enabling more effective and personalized guidance.
Final Takeaway
By shifting from weight-centered to behavior-focused, compassionate, and holistic conversations, clinicians can foster trust and empower patients to make sustainable, health-promoting changes. Weight is just one metric in a broader landscape of health and addressing it with sensitivity and respect can lead to better outcomes for both patients and providers.
Want more?
Check out this series of episodes about weight loss and empowering your patients!
Episode 29| Ask This Before Goin on a Diet- A Provider’s Guide to Helping Patients Lose Weight: Part 1
Episode 31| Beyond BMI- A Provider’s Guide to Helping Patients Lose Weight: Part 2
Episode 33 | End Emotional Eating- A Provider’s Guide to Helping Patients Lose Weight: Part 3
*this post was written by nutrition graduate student Nickie Patel.
