Important considerations for primary care clinicians1-3
- Evaluate your attitudes (and those of clinic staff you may work with) towards obesity and recognize that weight bias can affect patient behaviour and outcomes. Consider using the Harvard Implicit Test and Ontario Dieticians in Public Health resources to assess and address weight bias.
- Understand that patients may come with their own internalized weight bias that may take time to overcome. Assess patient perceptions of weight, considering cultural and socioeconomic contexts.
- Assess the office environment. Consider different ways to improve the patient experience such as access to bariatric chairs, chairs without armrests, accessible spaces, weight management as an online booking option, etc.
- Obtain patient consent before discussing weight issues and inform them about the health risks of obesity and central adiposity.
- Understand the importance of the patient-provider relationship and the time it may take to develop trust. Use non-judgmental language, images and practices. Refrain from assuming health concerns are related to body weight. Consider using Obesity Canada’s People First Language and Obesity UK’s Language Matters: Obesity resources.
- When discussing weight management strategies, ensure a patient-centered approach is used to develop a personalized and sustainable action plan. It is important to customize the program to fit the patient’s preferences, fitness level (e.g., pedal devices, chair-based exercises, etc.), health status and lifestyle. Consider using the following resources from Obesity Canada, RxFiles and Exercise is Medicine Canada.
- Consider non-weight goals (e.g., comorbidity management, quality of life etc.) rather than exclusively focusing on weight loss targets.
- Consider using devices to assist in assessment/management where appropriate (e.g., dynamometers, smart scales, etc.).
- Offer follow-ups and information regarding the benefits of weight loss for patients not ready to make changes. Clarify that obesity is a chronic medical condition with specific health implications rather than a matter of appearance.