Practical strategies should guide doctors' talks about weight

A new scientific statement offers advice on communicating evidence-based strategies about weight loss to overweight and obese patients.

The statement by the American Heart Association, which was published early online Aug. 8 by Circulation, divided strategies into three categories:

• appropriate ways to talk about body weight and readiness to change,
• collaboration among different clinicians, and
• information technology to deliver weight management programs.

The scientific statement concluded that because many weight management interventions involve understanding and applying detailed and sometimes complex information, the health literacy of patients should be taken into account in the design and selection of interventions. The statement suggested that clinicians refer to weight in a nonjudgmental, respectful and unhurried manner and assess readiness and ability to change behaviors before starting a specific strategy. It also recommended validated tools that assess behavior, including the Eating Pattern Questionnaire, the Starting the Conversation tool, and the WAVE and REAP-S tools.

Internet-based and other new technologies for weight loss have insufficient evidence to warrant their use in busy clinical settings, but they were included in the scientific statement because they have the potential to impact large numbers of participants and are relatively easy to recommend, administer, or refer to in such settings, the authors said. A subsequent scientific statement on adiposity will address assessing patients for overweight and obesity.

Future research should:

• Include diverse populations in the enrollment.
• Develop large studies that include technologically based interventions. Attrition rates from technology-based studies are very high, so there is a need to develop effective strategies to keep patients engaged in using technology tools for the long-term.
• Further evaluate collaborative approaches. Longer study durations are needed to evaluate the effectiveness of the chronic care model as a framework for weight management interventions.
• Explore the potential of electronic health records to identify, assess and deliver obesity interventions.

A recent article in ACP Internist discussed talking to patients about obesity.