Crucial conversations about weight management with healthcare providers: patients’ perspectives and experiences

  • Afton M. KoballEmail author
  • Paul S. Mueller
  • Julia Craner
  • Matthew M. Clark
  • Sanjeev Nanda
  • Esayas B. Kebede
  • Karen B. Grothe
Original Article



To elicit patient experiences of weight management discussions with providers and provide recommendations for future weight-related discussions.


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.


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).


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.


Obesity Weight management Communication 


Compliance with ethical standards


This study was funded by the Mayo Clinic Department of Medicine.

Conflict of interest

All authors declare no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Afton M. Koball
    • 1
    Email author
  • Paul S. Mueller
    • 2
  • Julia Craner
    • 3
  • Matthew M. Clark
    • 3
  • Sanjeev Nanda
    • 2
  • Esayas B. Kebede
    • 2
  • Karen B. Grothe
    • 3
  1. 1.Department of Behavioral HealthGundersen Health SystemLa CrosseUSA
  2. 2.Department of General Internal MedicineMayo ClinicRochesterUSA
  3. 3.Department of Psychiatry and PsychologyMayo ClinicRochesterUSA

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