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Tips For Gi Physicians To Start The Conversation With Patients ...

Tips for GI Physicians to Start the Conversation with
Patients about Overweight & Obesity from the American
College of Gastroenterology
Lisa Ganjhu, DO, St. Luke’s-Roosevelt Hospital Center, New York
Tools to Counsel Overweight & Obese Patients
Gastroenterologists can provide a valuable clinical service by
Available at www.acg.gi.org/obesity:
becoming actively involved in helping their obese patients
n Food and Exercise diary Studies have shown tracking
lose weight. First, and most importantly, educate the patient:
meals and adjusting intake as they go along will help with
inform them on the link between overweight and obesity and
weight loss
GI symptoms and illness. Most patients are unaware of the
n Guides to healthy eating at home and dining out
relationship. Let patients know that they have some control in
Educating the patients with healthy eating habits and setting
their health. Share the idea that managing their health is their
up and stocking a healthy kitchen pantry
responsibility.
n Calorie counts on common foods
once they understand and are willing to change, talk
n Tips on How to choose healthy restaurant and fast
to patients about the obstacles they might face. you
food options
might ask:
n Calorie expenditure chart to help burn off calories
n How did they get to their present weight?
n Internet links to Additional Resources
n How do they feel about their weight?
n What are their weight and health goals?
n Do they want to change and are they ready to change?
Principles of Effective Obesity Counseling
Discuss their options and whether they have access for
n Communicate empathetically
help in losing weight:
n Establish a patient-physician partnership
n Can they do it on their own?
n Deliver health counseling effectively
n Do they have a partner who shares the same or similar goals
n Be sensitive to bias against overweight and obese individuals
(e.g., a friend, sibling, or spouse)
n Do they have access to a gym or to weight loss programs such
as WeightWatchers™?
Strategies to Reduce Bias Against Overweight
& Obese Patients
It is essential to review these issues in a caring, supportive, non-
n Recognize that obesity is a chronic medical condition
judgmental fashion. Many overweight and obese patients feel
discriminated against and get defensive when discussing their
n Improve your knowledge of nutrition, multi-disciplinary
weight. It’s also important to create a friendly environment and
treatments and community resources
to develop a community to support your patients in your office.
n Create a friendly office culture and atmosphere
Time management issues can be supported by involving a PA/NP
or nutritionist. GI Behavior modification support from a mental
n Treat the overweight and obese population with respect and
health care worker may help to overcome the psychological bar-
support
riers to weight loss.
Using the American College of Gastroenterology Poster, “Obe-
sity: Know Your GI Risks,” show patients the BMI and waist
Source: Adapted from "Communication and Counseling Strategies" American
Medical Association 2003 Roadmaps for Clinical Practice, "Assessment and
circumference charts. Indicate where they fal on the grid and
Management of Adult Obesity: A Primer for Physicians"
show them the target range for their weight. Encourage patients
to set small goals of approximately 5 to 10 percent at a time.
AmericAn college of gAstroenterology