Initiating obesity discussions

To initiate a conversation with patients about excess weight, it is important to ask for permission first.1 Without permission, talking about weight may be a sensitive and unwelcome topic.

Different ways to get permission

Start with a general question

  • Tell me more about why you’ve come here today.
  • Do you have any other health concerns that you’d like to talk about?

Tie it to symptoms or other problems that the patient stated

  • Carrying excess weight can be a cause of some of your health concerns. Do you mind if we talk about how weight management could help with this problem?
  • Do you think your weight might be contributing to the problem that you’re having?

Refer to other clinical measures

  • I notice that your body mass index, or BMI, is high, which means you are carrying excess weight for a person of your height. This can affect your health. Is it okay if we talk about your weight?
  • If we can review your previous test results for a moment, I think it may be beneficial to discuss how weight management would help to improve some of these results in the future.
patient conversations

Just ask

  • Would it be all right if we discuss your weight?

If the patient seems unwilling or reluctant to discuss weight management, you can summarize and indicate that the patient is not concerned about his or her weight at this time. You can then assure the patient that if weight becomes a concern in the future, the topic can be revisited.


Also in Talking With Patients:


Related Information

Ask, Listen, Inform

Our video, “Discussing Weight with Your Patients,” can help you improve office conversations about obesity.

Patient Materials

Explore materials to help get your patients started with weight management.


  1. Vallis M, Piccinini-Vallis H, Sharma AM, Freedhoff Y. Modified 5 As: Minimal intervention for obesity counseling in primary care. Can Fam Physician. 2013;59:27-31.