About The Tool

Weight is a complex and sensitive issue, and conversations about weight can be challenging. Many factors are at play, not least of which may include feelings of failure, shame, and concerns about being judged by health care providers. Many providers have concerns about how to begin conversations about weight, what words to use, and how to communicate about weight while supporting their patients in ways that are empowering and nonjudgmental. Providers report minimal, if any, training on obesity, inadequate resources for effective conversations, and insufficient clinical time to devote to conversations about weight. Research has shown that behavioral and medical treatment can be effective, but improvised and uninformed discussions may disengage, stigmatize, or shame patients, to the detriment of the provider-patient relationship, obesity treatment goals, and patient outcomes.

This provider discussion tool, developed by the Strategies to Overcome and Prevent (STOP) Obesity Alliance, addresses many of these concerns. Our goal is to help providers have more effective conversations about weight and health with their patients. The guide focuses on skills for building a safe and trusting environment with patients and facilitating open, productive conversations about weight. It also provides potential scenarios that providers may face and suggests ways to approach the conversations.

We began the development of the tool by conducting an audit of available materials and research regarding these issues. This information, provided in Appendix A, informed an expert roundtable convened in May 2014. Roundtable participants were from a range of backgrounds including obesity practice and research, primary care practice, nutrition education, women’s health, minority health, and the patient community. Our discussions focused on how to help providers initiate and sustain productive conversations about weight and health in real-world practice settings and the constraints that limited these conversations.

This tool has been reviewed by a selected panel of experts and members of the STOP Obesity Alliance.

Thank you for taking the time to read this guide. Engaging health care providers like you will improve conversations about weight and health and encourage people to conduct more active dialogues with their health care providers.

Sincerely,
William H. Dietz, MD, PhD & Scott Kahan, MD, MPH 

Credits & Acknowledgements

This guide was developed in partnership between the obesity research team at Milken Institute School of Public Health at the George Washington University and the STOP Obesity Alliance communications team at Chandler Chicco Agency:

• William H. Dietz, MD, PhD, George Washington University
• Scott Kahan, MD, MPH, George Washington University
• Cristy Gallagher, George Washington University
• Christine Petrin, George Washington University
• Kaushika Prakash, George Washington University
• Gina Mangiaracina, Chandler Chicco Agency
• Melissa Warren, Chandler Chicco Agency
• Sarah Slotnick, Chandler Chicco Agency

The STOP Obesity Alliance would like to thank and acknowledge the following individual experts and organizations for reviewing and providing input on the guide:

• Angela F. Ford, PhD, MSW, Black Women's Health Imperative
• April Barbour, MD, GW Medical Faculty Associates
• Arya Mitra Sharma, MD, PhD, FRCPC, University of Alberta
• Bradley J. Needleman, MD, FACS, Ohio State University Surgery, LLC
• Brook Belay, MD, MPH, Centers for Disease Control and Prevention
• Dawn K.Wilson, PhD, Society of Behavioral Medicine
• Donna Ryan, MD, Professor Emeritus, Pennington Biomedical Research Center
• Ginger Winston, MD, MPH, GW Medical Faculty Associates
• Joe Nadglowski, Obesity Action Coalition
• Marijane Hynes, MD, GW Medical Faculty Associates
• Patricia Nece
• Patrick O'Neil, PhD, Medical University of South Carolina
• Pepin Andrew Tuma, JD, Academy of Nutrition and Dietetics
• Samuel Lin, MD, PhD, MBA, American Medical Group Association
• Scott Butsch, MD, MSC, Massachusetts General Hospital
• Ted Kyle, RPh, MBA, The Obesity Society
• Wendy K. Nickel, MPH, American College of Physicians

About the Strategies to Overcome and Prevent (STOP) Obesity Alliance

The Strategies to Overcome and Prevent (STOP) Obesity Alliance is a collaboration of more than 80 consumer, provider, government, business, and health insurer organizations working to drive innovative and practical strategies that combat obesity. With an academic home at The George Washington University’s Milken Institute School of Public Health (GW), the Alliance focuses on developing evidence-based reports, policy recommendations and tools. William H. Dietz, M.D., Ph.D. is the director of the Alliance and head of the Sumner M. Redstone Global Center for Prevention and Wellness at GW. The Strategies to Overcome and Prevent (STOP) Obesity Alliance has received funding from its founding sponsor, Sanofi U.S. LLC, and its supporting sponsor Novo Nordisk Inc. Additional generous support has been provided by Eisai, Co., Ltd., Ethicon U.S. LLC, Takeda Pharmaceuticals U.S.A., Inc. and members of STOP. For more information, visit www.stopobesityalliance.org and follow the Alliance on Facebook and on Twitter.