A Clinician's Guide to Discussing Obesity with Patients

This practical book provides effective, time-efficient strategies for initiating and continuing productive conversations about weight that can be incorporated into any practice setting. It will benefit all clinicians-advanced practice nurses, physician assistants, physicians-from students to experienced providers, whether they provide obesity treatment or refer to those who do.

This guide addresses the numerous barriers that clinicians encounter when they contemplate or attempt conversations about weight and provides strategies to reduce and overcome these barriers. It guides clinicians step-by-step through the concepts and skills needed to have conversations that lead to improved health. Each chapter provides useful tools and information about how to move the conversation forward in a respectful, skillful manner. Real life clinical scenarios provide examples of short, productive conversations that incorporate the tools into clinical practice.

Many clinicians recognize the importance of discussing weight with their patients yet feel unprepared to do so. Most did not learn about obesity or how to talk about it in their clinical educational programs and have little access to continuing education. Without the knowledge and skills to start a productive conversation, many avoid the topic. This avoidance has a negative impact on the health of those with obesity and pre-obesity. Given that obesity treatment improves outcomes, it is imperative that clinicians are skilled at discussing weight with knowledge and sensitivity. This book meets that gap.

Auteur

Sandra Christensen is a US board-certified nurse practitioner and has specialized in obesity treatment since 2005. She holds a Certificate of Advanced Education in Obesity Management from the Obesity Medicine Association (OMA). Ms. Christensen owns Integrative Medical Weight Management in Seattle, Washington, where she provides personalized, comprehensive obesity treatment in a comfortable, healing setting. She is a fellow of the Obesity Medicine Association and serves as a trustee on the OMA Board of Trustees. She is a contributing author of the OMA Obesity Algorithm, which translates the latest scientific literature and knowledge of experienced obesity specialists into evidence-based guidance in obesity treatment and is updated yearly. As a leader in the obesity treatment field, she is extensively involved in national and local programs and initiatives that educate clinicians about obesity, mentor those who are new to the field, and advocate for access to care. She speaks at local, state, and national conferences and webinars and has authored professional articles on the topic of obesity treatment.

Ms. Christensen has dedicated herself to educating others about the complexities of obesity. Through clinical practice, speaking, writing, and advocacy, she empowers patients and healthcare providers to address obesity with knowledge and compassion.

Contenu
Preface
An introduction that provides the rationale as to why it is important to initiate and continue conversations about weight and obesity. It will begin with a brief overview of the scope of obesity, with emphasis that it is a chronic, progressive, relapsing disease that is treatable, and that treatment improves health outcomes. Effective discussion between clinician and patient is needed to facilitate treatment. Whether the clinician treats the condition or refers to other clinicians, it is imperative that they approach these conversations with knowledge and sensitivity.
1)Understanding Obesity as a Disease
This chapter will educate clinicians about obesity by providing a brief overview of the disease and the complications that result from excess weight. It will also discuss the goals of treatment and the five comprehensive treatment modalities. This provides core knowledge that many clinicians are lacking.
2)Identifying & Reducing Weight Bias
This chapter will provide data on the prevalence and negative health effects of weight bias, with emphasis on weight bias in healthcare settings. Strategies will be provided to assist clinicians in recognizing and reducing weight bias in themselves and their patients.
This chapter will include 2-4 clinical scenarios that demonstrate:
•Clinical conversations during which a clinician conveys weight bias•Clinical conversations during which a patient conveys weight bias•A clinician recognizing and reducing his/her weight bias•A clinician recognizing and addressing the weight bias of the patient towards him/herself or others

3)Barriers to Discussing Weight
This chapter will introduce the barriers encountered by both clinicians and patients.
Clinician barriers include:
i)Lack of knowledge about weight and obesityii)Weight biasiii)Lack of knowledge about effective strategies for initiating and continuing productive discussions about weightiv)Concern that they will embarrass their patientsv)Misconceptions about patients' comfort discussing weightvi)Concerns about credibility if clinician carries extra weight (yes there is literature to support this.)vii)Timeviii)Reimbursement concerns
Patient barriers include:
ix)Lack of knowledge about weight and obesityx)Fear of being blamed and judgedxi)Fear of being given simplistic solutionsxii)Internalized weight bias and stigmaxiii)Patients want clinicians to initiate discussionsxiv)Results from the ACTION study. https://onlinelibrary.wiley.com/doi/full/10.1002/oby.22054

4)Creating An Environment for Effective Conversations to Take Place
The clinical environment sets the stage for effective conversations. The physical environment, as well as communication from the office and clinical staff, contribute to the experiences that patients with obesity have in healthcare settings.
This chapter will provide clinicians with information on how to provide a physical environment that is:
a)Safeb)Accessiblec)Accommodatingd)Comfortablee)Welcomingf)Non-shamingRecommendations for furniture, equipment, and patient gowns that accommodate larger bodies will be provided. Readers will learn about the importance of having health promoting, non-shaming literature in waiting rooms and treatment rooms, and using appropriate images and language on websites and promotional mat...