Talking With Patients

About Weight Loss: Tips for

Primary Care Professionals

As a primary care professional, you are in an ideal position to offer

weight-loss guidance to patients who are overweight or obese. You

need not be an expert in weight management or take a lot of time to

make a difference. A key first step in helping patients lose weight and

improve their health is opening a conversation. This fact sheet offers tips

that can help you talk with patients about this sensitive subject.

What role can primary care professionals play in patient

weight control?

Studies show that even short 3- to 5-minute conversations during routine

visits can contribute to patient behavior change. In one study, patients

who were obese and were advised by their health care professionals to lose

weight were three times more likely to try than patients not advised.

Research has also shown that patients who were counseled in a primary

care setting about the benefits of healthy eating and physical activity lost

weight, consumed less fat, and exercised more than patients who did not

receive counseling.

Unfortunately, the majority of primary care professionals do not talk with

their patients about weight. Most people who are overweight or obese

want assistance in setting and achieving weight-loss goals, but may 

hesitate to broach the topic during office visits. Talk with your patients

about their weight-related goals, acknowledging that weight management

is a challenging process. Explain that you want to help them lose weight,

to reduce their health risks and make them feel better, but assure patients

that your interest in their health is not dependent on their success in 

losing weight. 

What do patients want from health care professionals

regarding weight?

n Talk. Many patients want to talk about weight with health care 

professionals who offer respect and empathy for their struggles with

weight control. However, before starting a conversation about weight

control with your patients, give them a few minutes to discuss other

issues that may be affecting their physical or emotional well-being.

n Non-offensive terms. Patients prefer the terms “weight” or “excess

weight,” and dislike the terms “obesity,” “fatness,” and “excess fat.”

Research has

shown that

patients who were

counseled in a

primary care

setting about the

benefits of healthy

eating and physical

activity lost

weight, consumed

less fat, and

exercised more

than patients who

did not receive

counseling.

U.S. DEPARTMENT

OF HEALTH AND

HUMAN SERVICES

WIN Weight-control Information Network 
2

You can assume

your patient

already knows he

or she is

overweight.

Patients do not

want health care

professionals to

place blame or

attribute all of

their health

problems to

weight.

Which patients might benefit from a discussion

about weight?

Approach the subject of weight loss if your patient has

n Body mass index (BMI)* of 30 or above.

n BMI between 25 and 30 and two or more weight-related health 

problems, such as a family history of heart disease or diabetes.

n Waist measurement over 35 inches (women) or 40 inches (men)

—even if BMI is less than 25—and two or more weight-related 

health problems, such as a family history of heart disease or

diabetes.

Patients who are overweight (BMI between 25 and 30) and have one

or no other risk factors may benefit from a discussion about weight

gain prevention instead of weight loss.

*BMI = (weight in pounds x 703) ÷ height in inches squared. A complete BMI

table is available in Medical Care for Obese Patients, a fact sheet from the 

Weight-control Information Network.

Tips for Talking About Weight Control

1. Address your patient’s chief complaint first, independent of weight. 

You can assume your patient already knows he or she is overweight.

Patients do not want health care professionals to place blame or attribute

all of their health problems to weight.

2. Open the discussion. Open the conversation by finding out if your

patient is willing to talk about weight, or expressing your concerns about

how his or her weight affects health. Then, you might ask your patient to

describe his or her weight. Here are some sample discussion openers:

“Mr. Lopez, could we talk about your weight? What are your thoughts

about your weight right now?”

“Mrs. Brown, I’m concerned about your weight because I think it is causing

health problems for you. What do you think about your weight?”

Be sensitive to cultural differences that your patients may bring to the 

discussion regarding weight, food preferences, and related issues. Patients

may be more open when they feel respected.

n Advice they can use. Many patients want help setting realistic goals.

They may want to know what to eat and what and how much 

physical activity is appropriate. For example, some patients will want

to know how to become more physically active without causing

injury or aggravating problems such as joint pain. Others will want

advice on choosing appropriate weight-loss products and services. 
3

A patient who is

not yet ready to

attempt weight

control may still

benefit from a

discussion about

healthy eating and

regular physical

activity.

3. Decide if your patient is ready to control weight. Ask more questions to find

out how ready a patient is to control weight. Some sample questions are below.

“What are your goals concerning your weight?”

“What changes are you willing to make to your eating and physical activity

habits right now?”

“What kind of help would you like from me regarding your weight?”

A patient who is not yet ready to attempt weight control may still benefit

from a discussion about healthy eating and regular physical activity. A talk

focusing on the ways weight may affect your patient’s health may also be

appropriate. You can reassess the patient’s readiness to control weight at

the next office visit. A patient who is ready to control weight will benefit

from setting a weight-loss goal, receiving advice about healthy eating and

regular physical activity, and follow-up.

4. Set a weight goal. A 5- to 10-percent reduction in body weight over 6

months is a sensible weight-loss goal. One half to 2 pounds per week is a

safe rate of weight loss. A goal of maintaining current weight and 

preventing weight gain may be appropriate for some patients.

5. Prescribe healthy eating and physical activity behaviors. Give your

patient concrete actions to take to meet his or her weight goal over the

next 6 months. Write a prescription for healthier eating and increased

physical activity (see sample prescription on page 4). You could also direct

your patients to print or online resources about weight, healthy eating,

and physical activity. (Patient resources are listed on page 5.)

Another option is to refer patients to a weight-loss program or registered

dietitian who specializes in weight control. The American Dietetic

Association (www.eatright.org) offers referrals to registered dietitians

throughout the United States. In addition, the Weight-control

Information Network (WIN) brochure Choosing a Safe and Successful

Weight-loss Program can help your patients during this process. This 

publication offers a list of questions patients may ask their health care

providers before deciding on a weight-loss plan, and various tips on what

to look for in such programs. 

Some patients may benefit from a weight-loss medication or obesity 

surgery. The fact sheets Prescription Medications for the Treatment of

Obesity and Gastrointestinal Surgery for Severe Obesity from WIN offer

more information about these two treatments. Also, note that some 

people try herbal treatments to improve their health. Ask your patients if

they are taking herbals and provide advice on the use of these products.

For more information, contact the National Center for Complementary

and Alternative Medicine, which serves as a resource on herbs for 

professionals and the public (www.nccam.nih.gov).
4

A patient who is

ready to control

weight will benefit

from setting a

weight-loss goal,

receiving advice

about healthy

eating and regular

physical activity,

and follow-up.

Try these ideas to support your weight-loss efforts:

✔ Eat a variety of nutrient-dense foods from the basic food groups and limit

your intake of saturated and trans fats, added sugars, salt, and alcohol.

✔ Be physically active for at least 30 minutes on most or all days of the week.

This level of exercise helps reduce your risk for chronic diseases such as 

diabetes. Set goals for moderate-intensity physical activities, such as walking

at a brisk pace, and chart your progress as you increase your activity level. 

✔ Be physically active for 60 to 90 minutes a day if you are trying to lose

weight or sustain weight loss. Chart your progress as you increase your

activity level. 

✔ Take stairs instead of elevators, park further from entrances, walk instead of

watching TV after dinner. Make sure you are in locations that are both safe

and well-lit when engaging in these activities.

✔ Keep a food diary. Write down all of the food you eat in a day, what time you

eat, and your feelings at the time. Look at your diary to find ways to improve

your eating habits.

✔ Dish up smaller amounts of foods from a variety of food groups. Measure

your portions against the serving size listed on food packaging for a few days

so you know how much you are eating. You may want to consider the new

Dietary Guidelines for Americans 2005, which you can find online at

www.healthierus.gov/dietaryguidelines. 

✔ At restaurants, eat only half of your meal and take the rest home.

Prescription for Healthy Eating and RX Regular Physical Activity

6. Follow up. When you see your patient again, note progress made on

behavior changes, such as walking at least 5 days a week. If your patient

has made healthy behavior changes, offer praise to boost self-esteem and

keep him or her motivated. Likewise, discuss setbacks to help your patient

overcome challenges and be more successful.

Set a new weight goal with your patient. This may be for weight loss or

prevention of weight gain. Discuss eating and physical activity habits to

change or maintain to meet the new weight goal.
5

What patient resources are available?

Active at Any Size, a brochure from WIN to help very large people

become more physically active. National Institutes of Health (NIH)

Publication No. 04-4352. April 2004.

Better Health and You: Tips for Adults, a brochure from WIN on healthy

eating, part of the series Healthy Eating and Physical Activity Across Your

Lifespan. NIH Publication No. 04-4992. Updated June 2004.

Finding Your Way to a Healthier You: Based on the “Dietary Guidelines for

Americans,” a brochure from the U.S. Department of Health and

Human Services (DHHS) and the U.S. Department of Agriculture

(www.health.gov/dietaryguidelines/dga2005/document/pdf/brochure.pdf).

DHHS Publication No. HHS-ODPHP-2005-01-DGA-B. 2005.

SmallStep.Gov, a website from DHHS that helps users take small steps

toward a healthy weight (www.smallstep.gov).

Walking: A Step in the Right Direction, a pamphlet from WIN about 

beginning a walking program. NIH Publication No. 04-4155.

August 2004.

Weight Loss for Life, a brochure from WIN offering sensible 

weight-control advice. NIH Publication No. 04-3700. June 2004.

What health professional resources are available?

Aim for a Healthy Weight Education Kit. This patient education kit from

the National Heart, Lung, and Blood Institute (NHLBI) helps health care

providers develop effective weight management programs in their offices

or clinics (www.nhlbi.nih.gov/health/prof/heart/obesity/aim_kit).

NIH Publication No. 02-5212. 2002. 

Free BMI calculator for Palm® hand-held computers, available online at

http://hin.nhlbi.nih.gov/bmi_palm.htm.

Medical Care for Obese Patients, a fact sheet from WIN to help health

care providers offer optional medical care to patients who are obese.

This publication features a complete BMI table. NIH Publication No.

03-5335. February 2003.

The Practical Guide: Identification, Evaluation, and Treatment of Overweight

and Obesity in Adults, an 88-page guide from NHLBI for health care

providers about helping patients control weight. Includes tools for

patients (www.nhlbi.nih.gov/guidelines/obesity/practgde.htm).

NIH Publication No. 00-4084. October 2000.

Weight and Waist Measurement: Tools for Adults, WIN’s fact sheet 

describing how to accurately take these two measures and what their 

associated health risks are. NIH Publication No. 04-5283. June 2004.

If your patient has

made healthy

behavior changes,

offer praise to

boost self-esteem

and keep him or

her motivated.
Weight-control

Information

Network

1 WIN WAY

Bethesda, MD 20892-3665

Phone:

(202) 828-1025

Toll-free number:

1-877-946-4627

FAX:

(202) 828-1028

Email:

WIN@info.niddk.nih.gov

Internet:

www.win.niddk.nih.gov

The Weight-control Information Network

(WIN) is a national information service of

the National Institute of Diabetes and

Digestive and Kidney Diseases (NIDDK)

of the National Institutes of Health, which

is the Federal Government's lead agency

responsible for biomedical research on

nutrition and obesity. Authorized by

Congress (Public Law 103-43), WIN

provides the general public, health

professionals, the media, and Congress with

up-to-date, science-based health information on weight control, obesity, physical

activity, and related nutritional issues.

Publications produced by WIN are

reviewed by both NIDDK scientists and

outside experts. This fact sheet was also

reviewed by Benjamin Caballero, M.D.,

Ph.D., Professor of International Health

and Pediatrics, Director of the Center for

Human Nutrition, Johns Hopkins

University. A review was also conducted by

Shiriki K. Kumanyika, Ph.D., M.P.H.,

Associate Dean for Health Promotion and

Disease Prevention, Director of the

Graduate Program in Public Health

Studies, Professor of Epidemiology,

Department of Biostatistics and

Epidemiology, University of Pennsylvania

School of Medicine.

This publication is not copyrighted. WIN encourages

users of this fact sheet to duplicate and distribute as many copies as desired.

This fact sheet is also available at

www.win.niddk.nih.gov.

October 2005