In your struggle with obesity have you spoken with your general care physician about your weight and how to manage lifestyle and diet to lose weight and decrease your health risks associated with obesity?  Most of us have never had "the talk" with our primary care doctor.

A new study of 1,500 people sheds light on the doctor-patient communication breakdown when it comes to discussing body weight as a health issue.  Doctors are reporting they counsel their overweight and obese patients about diet and exercise. But patients in the survey tell a different story: nearly half say they've never discussed their weight, body mass index (BMI), diet, or exercise with their physician.

Researchers from the Obesity Action Coalition (OAC), The Obesity Society (TOS) and pharmaceutical company Eisai wanted to have a better understanding of the communication regarding weight management between physicians and patients. In a survey of patients they talked to 1,009 adults in the "patients" group.  A separate survey of 501 physicians was conducted by the same coalition. The survey asked all participants the same questions.

This really isn't breaking news to those of us who struggle with obesity. Right now, as you read this, you are likely remembering a painful and uncomfortable encounter with a health care professional regarding your weight. I remember like it was yesterday an appointment with my general care doctor in 1997. As I exited the health consultation with my doctor he handed me a written "prescription" to speak to a nutritionist about my weight.  We had not discussed my weight in that appointment nor in prior appointments. I was humiliated as I read the prescription while my doctor disappeared down the hall without a word.  You can be confident that prescription immediately went to the trash and my association with that doctor was over. Here he was my caregiver and he made me feel my obesity was so vulgar and grotesque that even speaking about was unthinkable.  "My God!" I wondered, "does he think my fat is contagious?"

While the topic of obesity may be uncomfortable for a patient or a doctor to discuss, the fact is, weight management is crucial to good health, longevity, and reducing the risk of other diseases. 

Joe Nadglowski, CEO and president of Obesity Action Coalition (OAC), says that with obesity rates continuing to rise across the US, the relationship between physician and patient is "critically important" in the evaluation and treatment of patients who are overweight or obese.   "We need to educate patients to have the conversation about their weight and ask the right questions so they leave the doctor's office feeling empowered to take steps toward managing their weight. We also need to encourage physicians to facilitate the weight discussion with their patients, as it is often a difficult topic to discuss."

Experts suggest patients take the initiative for open and honest communication with their doctors about weight management.  Many WLS patients seek the care of a bariatric surgeon independently, without a referral from their general care physician. Like so many of you, I found my WLS team provided kindness, compassion, support, and professionalism in helping me make critical lifesaving choices including weight management with bariatric surgery. For the first time in my life I came to believe that my obesity was not vulgar and grotesque: Obesity is a metabolic disorder influenced by genetics and environment for which there was a medical resolution.  My bariatric center became my safe haven and as far as I was concerned they were all rock stars.  Many of you have shared similar stories.

The nirvana and profound peace we find at our weight loss surgery centers cannot last forever - at some point we will return to our general care doctor. Leaving the compassion and warmth of the bariatric center to return to an awkward meeting with my everyday doctor left me cold.  According to the NIH, "The three main goals of current doctor-patient communication are creating a good interpersonal relationship, facilitating exchange of information, and including patients in decision making." The burden of these goals falls upon the doctor because as patients we are under his care and authority. However, we can enter the doctor's office prepared to ask questions that we deem important.  Write down your questions to prompt the conversation. Set emotions and old wounds aside and listen with an open and thoughtful mind. Avoid filtering topics that are uncomfortable or embarrassing. Be brave: this is your life and health at stake.

Some researchers believe discussions of obesity and weight loss will become easier in the near future. "In this last year alone, we've seen tremendous strides made in the way society talks and thinks about obesity. There's been recognition of obesity as a disease and advances in medicine to help those struggling with obesity. However, the conversations happening in the exam room have yet to catch up," says Francesca Dea, executive director of The Obesity Society (TOS).
Whether the root cause here is a lack of understanding, different personalities, the psychology of having these uncomfortable conversations or a combination of factors, the goal is to improve physician-patient conversations to engender shared interest and investment in the overall improvement of health.