title: Crucial conversations about weight management with healthcare providers: patients' perspectives and experiences.
abstract: OBJECTIVE
  To elicit patient experiences of weight management discussions with providers and provide recommendations for future weight-related discussions.
  
  
  METHODS
  1000 patients who recently saw their provider for non-weight specific appointments were mailed measures of demographics, self-reported height and weight, activity level, adherence, perceptions of and recommendations for weight-related discussions, and internalized weight bias. This study was primarily descriptive and utilized a mixed method design including collection of quantitative and qualitative data.
  
  
  RESULTS
  242 patients responded (24 % response rate); 32.4 % overweight (N = 72), 41.9 % obese (N = 93). 47 % of overweight and 71 % of obese patients recalled that their provider discussed weight; 92 % were motivated to follow recommendations and 89 % felt confident doing so. Most patients (75 %) would like their provider to be "very direct/straightforward" when discussing weight, and 52 % would be "not at all offended" if they were diagnosed as "overweight/obese." Most patients (63 %) reported being "extremely comfortable" discussing weight with providers. Patients with higher BMI had higher levels of internalized weight bias (p < .001) and wanted their provider to "discuss weight sensitively" (p < .05).
  
  
  CONCLUSIONS
  This study suggests that patients have important preferences that providers should be mindful of when discussing weight. While these discussions can be challenging, most patients report that they would be comfortable having these conversations directly and most would have enhanced motivation and confidence following these conversations. Communicating about weight is needed and desired by patients; doing so sensitively with those at higher weight is essential.
authors.affiliation: Department of Behavioral Health, Gundersen Health System, 1900 South Avenue, La Crosse, WI, 54601, USA. amkoball@gundersenhealth.org.
authors.forename: Afton M
authors.initials: AM
authors.lastname: Koball
authors.affiliation: Department of General Internal Medicine, Mayo Clinic, Rochester, MN, 55905, USA.
authors.forename: Paul S
authors.initials: PS
authors.lastname: Mueller
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, 55905, USA.
authors.forename: Julia
authors.initials: J
authors.lastname: Craner
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, 55905, USA.
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Clark
authors.affiliation: Department of General Internal Medicine, Mayo Clinic, Rochester, MN, 55905, USA.
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Nanda
authors.affiliation: Department of General Internal Medicine, Mayo Clinic, Rochester, MN, 55905, USA.
authors.forename: Esayas B
authors.initials: EB
authors.lastname: Kebede
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, 55905, USA.
authors.forename: Karen B
authors.initials: KB
authors.lastname: Grothe
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001835:Body Weight / Q000502:physiology*; D003142:Communication; D005260:Female; D006282:Health Personnel; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009765:Obesity / Q000628:therapy*; D050177:Overweight / Q000628:therapy*; D057240:Patient Preference; D010817:Physician-Patient Relations
keywords: Communication; Obesity; Weight management