Main components of a focused weight-history discussion

Use these talking points and questions to discuss a patient’s weight history.

Changes in weight over time

Each patient will have gained weight differently. Understanding how and why his or her weight has changed can provide insight into weight-gain triggers.1

Some talking points and questions:

  • When do you think you first began to gain weight?
  • Do you feel as if your weight has been an issue in the past? For how long?
  • Have you always carried excess weight?


Factors in weight changes

This discussion involves eliciting your patient’s perceptions of causes as well as connecting any past medical causes to changes in weight.1

Some talking points and questions:

  • Why do you think weight is a problem for you?
  • Can you think of any times in your life when you found that you put on a lot of weight?
  • What do you think was the reason for putting on weight at that time?
  • How do you handle stressful situations? Boredom? Sadness? Tiredness?


Descriptions of past weight-loss efforts

Discuss and understand your patient’s past efforts with weight loss, including specific programs or plans, duration, and results.2

Some talking points and questions:

  • Tell me about your efforts with trying to lose weight in the past.
  • Can you describe the program or type of plan that you followed?
  • How long did you stay engaged?
  • What aspects of those programs or plans were successful for you?
  • What didn’t work for you? What roadblocks did you encounter?
  • What has triggered your past weight-loss efforts?


Current habits

A discussion about your patient’s current eating and activity habits and how he or she might feel about changing his or her current habits.3,4

Some talking points and questions:

  • In general, how often do you feel hungry on a scale of 1 to 10, with 1 being “hardly ever hungry” and 10 being “you are always thinking about food”?
  • Tell me about your current eating habits.
  • What kinds of things have you done to change your eating?
  • How do your current habits compare to your past efforts with weight loss?
  • Tell me about your current physical activity habits.
    On a scale of 1 to 10, how ready are you to make changes in your current activity patterns?


Also in Talking With Patients:

    

Related Information


The Weight Conversation

This video provides tips on productive discussions about weight with your patients.


The Science of Obesity

Learn about the science behind the causes, effects, and management of obesity.

References:

  1. Kushner RF. Clinical assessment and management of adult obesity. Circulation. 2012;126(24):2870-2877.
  2. Jensen MD, Ryan DH, Apovian CM, et al; American College of Cardiology/American Heart Association Task Force on Practice Guidelines; Obesity Society. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation. 2014;129(25 Suppl 2):S102-S138.
  3. Kushner RF. Roadmaps for Clinical Practice: Case Studies in Disease Prevention and Health Promotion—Assessment and Management of Adult Obesity: A Primer for Physicians. Booklet 4: Dietary management. Chicago, IL: American Medical Association, 2003.
  4. Kushner RF. Roadmaps for Clinical Practice: Case Studies in Disease Prevention and Health Promotion—Assessment and Management of Adult Obesity: A Primer for Physicians. Booklet 5: Physical activity management. Chicago, IL: American Medical Association, 2003.