How to discuss weight loss with patients and provide ongoing support

Health coach Zaytun Ratansi offers advice on how GPs can raise the issue of weight loss with patients and explains the importance of ongoing support to help patients make healthier lifestyle choices.

(Photo: RyanKing999/Getty Images)
(Photo: RyanKing999/Getty Images)

A recent report by the British Psychological Society has called for changes in the way health professionals talk about weight loss to their patients. The goal is to help reduce stigma and ensure health professionals are trained to talk about weight loss in a more supportive way. 

The report highlights that trauma and stress are two of the main reasons  why people become obese. It states that ‘people who live in deprived areas often experience high levels of stress, including major life challenges and trauma, often their neighbourhoods offer few opportunities and incentives for physical activity and options for accessing affordable healthy food are limited’. 

That said, to ensure we tackle the soaring obesity rates here in the UK, we need to keep in mind these psychological factors when diagnosing and treating patients.

As a health facilitator at Living Well, Taking Control, a local NHS Diabetes Prevention Programme service, I advise hundreds of patients on how to lead a healthy lifestyle with practical tips for weight loss.

The following tips and resources can help health professionals discuss this sensitive topic with patients and make sure they are on track with their goals.

Raising the topic

Patients will be hesitant to accept that their weight is the cause of their symptoms. Address your patient’s main health concerns first. Let them talk about why they have come to see you and what they believe to be the day-to-day causes to their physical health – whether that be family problems or work stress.

Once those issues come to the fore, ask them how it affects their lifestyle specifically their eating and fitness habits. This allows you to open the discussion about weight in a way that is led by the patient.

Once you have both recognised that weight is an issue, start going into detail on the health risks associated with obesity.

Educating patients

Education is an important part of discussing weight loss. Many of the patients I treat every day lack the basic knowledge around healthy eating and lifestyle. As a result, they are unable to make the choices that allow them to lose – and keep off  –their weight off.

Providing patients with the right information on the benefits of a balanced diet and exercise at the onset of diagnosis can help mitigate risks.

Highlight the basics of portion control and how to read labels. Direct patients to resources, such as the NHS Eat Well guide.

It’s also important to provide education around activity levels and the recommended amount of exercise.

The NHS has hundreds of guides for lifestyle management and it’s our job to choose the right resources and support for the need – the advice you provide may differ for each individual. 

Collaborate on goals

Discussing the patient’s goals and objectives at the beginning of lifestyle intervention will help to give them a clear direction.

Start by providing simple recommendations around the guidelines of weight loss, calorie intake and physical activity, which will help patients understand where they need to be.

When approaching a weight loss conversation, consider mobility factors and how patients can easily introduce exercise within their lifestyle.

If patients are given goals which are too far out of reach, or difficult to implement, they simply won’t be able to maintain their lifestyle change. This will knock their confidence dissuade them from further action.

Patients really value this open dialogue, which can help them to feel empowered to take back control of their diet and activity levels. It is the patient’s responsibility to implement our advice –we can’t do it for them, but we provide them with advice and support.

NHS Diabetes Prevention Programme

To bring these ideas to patients across England, NHS England is rolling out a programme of support – Healthier You: NHS Diabetes Prevention Programme. The programme provides combination of group support and digital tools to help those living with obesity and at risk of developing type 2 diabetes. It provides guidance on eating healthily, managing weight and being more active.

GPs can refer patients diagnosed as pre-diabetic to the programme. The programme starts with a one-to-one assessment with a health coach like myself, who will discuss the patient’s individual needs, motivations and goals. The patient then joins a local group where they can discuss a variety of topics, including healthy eating, physical activity and positive mental health. We also provide patients with information to help them set some personal goals to make simple, but important, changes to their lifestyle.

Ultimately, there is only one solution to the growing challenge of obesity in the UK - a lifestyle change. This is often a major mental challenge for patients, but with the right help and support there is reason for optimism.

With new digital tools and programmes we can make a difference to even more patients. Opening up the conversation is the first step in a long journey for patients. By tackling the weight loss conversation in a supportive way, we can help change patients’ lives.

  • Zaytun Ratansi is a health coach at Health Exchange and works as part of Living Living Well, Taking Control to deliver the Healthier You: NHS Diabetes Prevention Programme. She has over 13 years of experience of supporting individuals to make healthier lifestyle choices

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