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Obesity and Your Practice – How To Bridge The Gap From Conversation to Weight Loss

By Karol Clark, MSN, RN


It’s a New Year and you are positioned perfectly to help your overweight patients lose weight!  It all begins with one respectful and caring conversation.


As you are aware, about 70 percent of adult Americans are overweight (BMI >25) and of these, nearly 40% are considered obese (BMI >30).  This extra weight puts them at risk for developing heart disease, type 2 diabetes, kidney disease, stroke, and certain cancers.1 It has also been confirmed that being obese increases the risk of serious illness from COVID-19.2  Not to mention the adverse effects on their musculoskeletal system which you treat every day in your practice.  If this wasn’t enough, obesity and being overweight are the second leading preventable cause of death in the USA.3


Many will attempt weight loss on their own this year and hopefully be successful.  However, studies show that approximately 80% of people who make New Years resolutions fail by the beginning of February and sustained weight loss failure statistics are even worse.


This serious epidemic requires the attention of all healthcare professionals with the desire, knowledge, and skill to help make a difference.  Especially since even modest, sustained weight loss of 5% to 10% can improve their overweight patient’s health and reduce their comorbid risks.


And yet, the conversation and effective treatment can be daunting and difficult, mainly due to potential barriers such as:

  • Being unsure how to begin the conversation
  • Limited time to spend with each patient
  • Minimal obesity training
  • Inadequate resources for effective comprehensive counseling and treatment
  • Fear of adversely affecting your provider-patient relationship


Let’s tackle this together!  After working with weight loss practitioners and overweight patients for nearly two decades, here are some proven ways to overcome these issues and effectively bridge the gap from initial conversation to helping your overweight patients experience weight loss success with the potential added benefit of adding additional revenue stream(s) into your practice.


Setting the Stage for Success

Obesity is a complex topic and one that must be understood to avoid unintended perceived blame or shame by your patient.  Patients are often embarrassed to discuss their weight or sometimes tend to overcompensate with laughter or jokes.  Ensuring your entire team is aware and respectful of such feelings will help your patients feel comfortable from their first phone call to your office and throughout their entire patient care experience.


In addition, your office environment can help set you up for successful conversations.  Having waiting room chairs that can support higher weight (without arms), having a higher capacity scale that is in a private area, pedestal toilets instead of wall mounted, larger gowns as necessary in addition to any patient care equipment (i.e. BP cuffs, massage & treatment tables) that can accommodate patients 300+ pounds.


Finally, avoiding such words as ‘fat’ and ‘obese’ is helpful as these carry negative connotations.  Utilizing ‘overweight’ or referring to BMI is typically better received.  Bottom line, as with everyone (myself included), your overweight patients just want to be understood and cared for in a compassionate, accepting, and pleasant way.  They want to belong and feel as if they are being heard in a non-discriminatory way.  They want to be respected and treated fairly without bias.


Starting the Conversation

The first step is to get permission to talk about excess weight.  Lack of permission can be viewed as being insensitive and potentially rude.  You can broach the topic in a variety of ways such as linking it to a problem or symptom they present with at the time of their visit or politely asking directly.  Here are some examples:


“Having excess weight can contribute to the pain you are experiencing. With your permission, can we talk about how weight management might help you with your pain?”

“Helping you with your overall health is an important goal of mine. With your permission, can we talk about your weight today?”


Starting the conversation in this way can be an effective gateway to assess their concerns and goals.  This will help you establish your plan of care and provide you with information to inspire them to consider beginning their weight loss journey and help keep them motivated as they continue with their plan of care.


Establishing a Weight Loss Plan

The issue is much more than ‘eating less and moving more’ – advice that often causes more harm than good.  And at the risk of great debate and potential criticism, the weight loss plan that is best for your patient is the one that they can commit to doing (and does no harm)!  I have my own views regarding adequate protein/low carb; keto; intermittent fasting; VLCD; LCD; vegan; gluten free and other available plans. However, no matter what, there must be a balance that is sustainable for your patient as well as comprehensive (i.e. nutrition, behavior & fitness based) for long-term success.  In addition, you must keep your patient engaged and accountable for best results.


This may sound daunting and confusing, but the end goal can be accomplished in a variety of ways.  Let’s explore the options:

  1. Create your own comprehensive weight loss program that includes patient education, 1:1 coaching/accountability, behavior modification and fitness recommendations with or without insurance. It has never been as easy to create programs that are easily accessible online, on-site or as a hybrid model.  In fact, there are a variety of ‘turn-key ‘programs you can utilize.
  2. Team up with a bariatrician or bariatric surgeon in your area for a referral relationship or combined care model to support your patients that need to lose weight.
  3. Offer motivational Jump Start programs that involve high quality nutritional supplements available through your office and/or challenges that create immediate weight loss success and motivation to keep going with you and your team.


At the very least, provide your patients with a referral to a reputable weight loss program in your area or provide them with a guide to getting started on their weight loss journey.  If you need such a ‘starter guide’, let me know.  I have one you can customize with your name/branding that includes 12 Steps to Weight Loss Success that works well – simply reach out to me at .


Be sure to communicate with the patient’s primary care provider.  This increases your reach/exposure and demonstrates that you are committed to an optimal outcome with your patient.  It is important to understand that if your patient isn’t offered weight loss support (or high-quality nutritional products) from you, they will seek it from another source even if sub-standard.


Adding weight loss products and services can be a way to help your patients as well as create additional profitable revenue streams to your practice.  From product sales to online programs and onsite support, the options are many.  The important thing is to offer services that are effective, keep your patients engaged (and coming back) as well as creating an ongoing referral source for you and your practice.


Ongoing communication, marketing and motivation has also never been as easy as it is today.  Effective utilization of social media, weekly e-mails, text messaging and on-site promotion makes promotion of your services and products easy and very affordable.


Your overweight patients trust you and need you now more than ever.  It all begins with a conversation.





Additional Resource:


*First published in Chiropractic Economics Magazine, Jan 21, 2021 – Vol. 81, No. 1, January 17, 2021

Karol Clark, MSN, RN is the best-selling author of How to Add Medical Weight Loss to Your Practice: 7 Steps to an Enjoyable Business, Healthier Patients and Increased Profitability and owner of Weight Loss Practice Builder and the exclusive membership program for weight loss practitioners   She has over 20 yrs. of experience working with surgical and non-surgical weight loss patients and assisting physicians build an enjoyable weight loss practice. She partners with Nutritional Resources (d/b/a for creation of educational programs/articles for weight loss practitioners.