Primary care clinicians are often the frontline providers for mental health support, especially for patients with obesity, and it’s long been known that there is a direct link between obesity and depression for many.

“A compassionate, nonjudgmental approach to screening for symptoms of depression is recommended as part of the evaluation of patients who are diagnosed with obesity,” said Samar Hafida, MD, vice president of the Obesity Association, a division of the American Diabetes Association, who is based in Boston.

“To address this, primary care providers should routinely screen for depression using simple tools like the PHQ-2 or PHQ-9, introducing screeners in a way to normalize conversations about mental health,” said Scott Isaacs, MD, past president of the American Association of Clinical Endocrinology, and an adjunct assistant professor of medicine at Emory University in Atlanta. “When depression is identified, combining counseling and medication can be highly effective. Collaborating with behavioral health specialists helps patients receive care that supports both their mental and physical health.”

Discussing Medications and Counseling With Patients

If you recognize that a patient with obesity may benefit from mental health support, introduce counseling as a routine part of comprehensive care, Isaacs said. Explain that just as you address physical health, emotional well-being is important for managing chronic conditions. “Let patients know that counseling offers a safe space to talk, validate their feelings, and learn strategies to improve mood and outlook,” he said.

Primary care doctors play a key role in normalizing mental health care and presenting it as a common, proactive step toward holistic care.

“They should recognize the importance of screening with validated tools, discuss the benefits of addressing symptoms, and acknowledge that insurance coverage and financial constraints are legitimate concerns,” Hafida said. 

Most insurance plans, including Medicare and Medicaid, do cover visits for behavioral health just like medical visits, said Hafida. “Community resources for urgent behavioral health needs also exist, and most primary care clinics can provide resources to connect their patients with experts,” Hafida noted.

Key Points: When GLP-1s Can Help a Treatment Plan

When discussing medication options for patients with obesity, approach the topic with empathy and respect for the patient’s efforts. Start by acknowledging the hard work they have already put into lifestyle changes such as exercise and healthy eating, said Isaacs. 

“Explain that sometimes, despite these efforts, additional support may be helpful, and that medications can serve as another tool to help them reach their health goals. Emphasize that weight management is not about willpower but about making healthy choices,” he noted.

Throughout the conversation, focus on the patient’s goals, invite their questions, and reassure them that you are working together as a team to support their overall well-being. 

If your assessment warrants, consider suggesting GLP-1s. When discussing self-injectable medications for obesity, clearly explain both the benefits and possible risks to your patients. This may also be an opportunity to discuss the availability of the pill form. 

“Let them know these medications can support weight loss and improve conditions like diabetes and heart disease, but may also cause side effects such as nausea or, rarely, more serious issues,” Isaacs said. Encourage questions and reassure patients that you will monitor their progress and address any concerns that arise.

Remain Patient-Focused

Addressing both obesity and depression within primary care requires a thoughtful, patient-centered approach that emphasizes the connection between physical and mental health, asserted Isaacs.

“By normalizing conversations about emotional well-being, offering clear information about counseling and medication, and encouraging open dialogue, primary care doctors can help patients feel supported and empowered,” Isaacs said.

Furthermore, primary care doctors play a vital role in treating patients with obesity, diabetes, cardiac, or pulmonary conditions, who may also be struggling with depression. When suggesting counseling or medication, approach the conversation with empathy for the patient’s experiences.

“Emphasize that mental and emotional health are just as important as physical health, and that counseling offers a supportive space to talk through challenges and develop coping strategies,” added Isaacs. “Let patients know you are there to help them.”