Patient interactions are an important element of obesity case management, and proactive strategies and communication can enhance patients' health routines. These strategies can include patient-centric philosophies, improving clinical interactions and enhancing broad healthcare experiences both during an appointment and after. 

Remaining Focused on Trends in Patient Healthcare 

A surge in GLP-1 medications has likely ramped up discussions of obesity in your practice. As this trend continues, interactions with patients with obesity should continue to be supportive, nonjudgmental and clinically focused. 

Respect is paramount and primary care physicians (PCPs) should think carefully about language, tone, and recommendations. 

“Patients living with obesity are frequently exposed to weight stigma through social interactions, media, and healthcare experiences. There is a discrepancy between the scientific understanding of obesity and conventional beliefs about its causes,” said Roseann Day, MD, an assistant professor of family medicine and community health at Perelman School of Medicine at the University of Pennsylvania in Philadelphia. 

Often those “conventional” beliefs result in stigmatization of a person living with obesity as lazy, undisciplined, and sedentary. In truth, the mechanisms underlying obesity are complex, Day said, and there is evidence to suggest that up to 80% of obesity is determined by genetic factors. 

The messaging and interactions between healthcare and patient are significant. 

Research has revealed weight stigma can cause internalized weight bias, where patients label themselves with negative weight stereotypes. 

“Weight stigma can evoke a variety of responses in a patient, both physiologic and behavioral, that perpetuate weight gain and lead to poorer health outcomes,” Day said. 

That makes it crucial, she said, that patients living with obesity receive nonjudgmental and collaborative care from their healthcare teams. Primary care physicians are the front line in screening for obesity-related chronic disease and helping patients formulate a personal plan for lifetime healthy weight management.

Moreover, using person-centered language and collaborative goal setting are important pillars of care for patients living with obesity. It’s recommended, said Day, to use “person living with obesity or overweight” rather than “obese or overweight person.”

Have a Goal to Personalize Treatment Plans

A more patient-focused approach is to identify objectives that align with their individual lifestyles and aspirations. For example, a meaningful goal might be helping a patient achieve enough stamina to play with their grandchildren without feeling fatigued, said Day. 

“Similarly, providers should emphasize the positive outcomes of a weight management treatment plan, rather than highlighting the threat of negative consequences of not losing weight,” she said. 

This further strengthens the patient–clinician partnership and promotes healthier behaviors.

A comprehensive healthy weight management plan should include not only recommended lifestyle changes but also treatment for any psychological comorbidities, addressing relevant social determinants of health, and implementing pharmacologic and/or surgical interventions as indicated, said Day.

Demonstrating Measures and Empowering Patients 

Providing clear explanations of relevant mechanisms and, where appropriate, demonstrating the initiation and execution of minor health interventions can greatly support patients’ understanding and engagement. 

“It is important to demonstrate to patients how to carry out specific health measures, such as checking home blood pressure readings, because it ensures that patients have the knowledge to perform these tasks correctly,” Day said.

Additionally, it increases patients’ confidence in their ability to take these steps at home. Tracking the response of obesity-related chronic conditions, such as hypertension, is important. 

“Patients who check their blood pressure at home can see a concrete response to a weight loss treatment plan, which can further motivate adherence to the plan,” she said.

Another suggestion for patients could be a nutrition diary. 

“This is a helpful tool for providers and registered dietitians to learn about a patient’s dietary patterns and intake,” Day said. Clinicians should demonstrate and make sure patients know how to use the tool to reduce frustration later. 

Multiple studies show that consistent food logging supports greater weight loss.

Also, encourage patients to chart their sleep. This self-advocacy move shows sleep is a critical part of any comprehensive health plan. Sleep deprivation can trigger changes in hormones, reduce satiety, increase hunger, and increase insulin resistance. 

In addition, poor sleep can exacerbate mood symptoms, impair cognitive function, and increase pain, all of which can hinder an individual’s ability to stick to a health plan, she said. 

There’s not as much evidence to show that tracking sleep improves sleep. “It can be a helpful tool for identifying any problems with sleep and providing practitioners with information on what type of sleep interventions to make,” Day said. 

Why PCP Involvement Matters

Changing habits is difficult, as complex biological factors can make weight loss challenging and affect a patient’s diet choices and energy levels. 

“As with any chronic medical condition, clinicians should approach management in a patient-centered fashion, involving the patient and family in the discussion about health behavior change,” said Courtney Batt, MD, assistant professor, Case Western University School of Medicine in Cleveland, Ohio.

Beyond situational awareness and small implementation, there are also short-term tweaks that PCPs can suggest. 

“I tell my patients that there are many factors that we have no control over, such as our genetics, our hormones, the environment that we live in, and the food environment that we are all exposed to; however, there are areas that we have some agency over, and these are things like nutrition choices, physical activity, and sleep habits,” Batt continued. “Having patients set even one goal that is an improvement in one of these domains can be helpful.”

Should PCPs Advise Patients to Do Regular Weight Checks?

Regular, but not obsessive, self-weighing helps patients recognize weight trends over time, said Farah Deshmukh, MD, MPH, internal medicine and obesity medicine physician at Jersey Shore University Medical Center in Neptune, New Jersey. “Framing weight as neutral data rather than a judgment allows for more productive discussions during follow-up visits, particularly when interpreting short-term fluctuations related to fluid shifts, diet, or stress,” she said.

Day, Batt, and Deshmukh reported no relevant financial relationships.