It can be difficult to finding the right way to talk about lifestyle concerns like obesity or smoking with patients, but there are a variety of routes you can follow — some more effective than others.
Lack of time can be an obstacle to these discussions, as can uncertainty about what language to use, or fear of upsetting the individual.
Choosing your words and your moment carefully is vital. Give patients just the right nudge, so they begin to move towards a healthier and happier way of life.
Well-planned, short-term interventions have been proven to increase the chances of a patient making successful changes in their lifestyle. Public Health England cover this in their guide Let’s Talk About Weight.
The earlier you offer support, the easier it will be for your patient to form healthier habits. The fear of the conversation can be worse than the reality — and we find many people actually welcome the support.
We hope you’ll find the following tips useful:
Acknowledge the stigma
A lot of patients will feel stigmatised for their conditions. Nature Medicine published a paper on World Obesity Day 2020, with an international consensus statement on ending the stigma of obesity.
This expressed that many obese people face social stigma that they have a lack of self-discipline and personal responsibility.
This is backed up by evidence from the UK Government All-Party Parliamentary Group on Obesity. It has published a report saying: “94% of respondents believe there is not enough understanding about the cause of obesity amongst the public, politicians and other stakeholders.”
Obesity has a complex set of causes, including biology, psychology, environment, and financial situation. Societal and cultural influences also play a role, particularly the availability of unhealthy foods.
The stigma can become internalised, creating negative repercussions for physical and mental health. People may be put off making positive changes or taking preventative measures.
But a conversation about lifestyle concerns could make a difference.
Listen and empathise
Remember you are dealing with an individual. Try to understand how they will be feeling. Don’t make assumptions and try to understand their point of view.
You could begin with open questions. Practice active listening, understanding what they say, then reflecting and responding.
You could begin your reply with:
- Sounds like…
- I can hear that…
- I can see by your expression that…
These show you have heard what they have said, which is critical before touching on sensitive subjects.
Ask them
How do they describe themselves? If you are unsure what they mean by any words, ask them to clarify — and try not to correct them or finish their sentence.
Focusing on the words they use to describe their lifestyle can help to explore any internal bias your patient might have.
It is important to understand their priorities and goals. Focus on what they want to achieve, rather than what you think they should do.
Seek permission
If your patient has not raised concerns about their lifestyle, you should ask permission before discussing it.
You could directly ask: “Is it OK to talk about smoking?”
Or approach it indirectly and ask:
- “Do you have any concerns about your health and lifestyle at the moment?”
- “Are there any areas of your general health I might be able to help with? Some of the most common things people talk to me about include sleep, eating…”
- “Is your health/weight something you are worried about?”
- “What does your lifestyle look like at the moment?”
- “The things you have raised can lead to being above a healthy weight for some people. Is that something you are worried about?”
Be sure to take a different approach each time you see the same patient, to avoid repeating yourself.
Language matters
Think about the language you use, along with your tone and gestures.
Avoid saying:
- Too much about negative consequences, e.g., “’If you don’t lose weight, you will get diabetes”
- Blaming or shaming things, e.g. “You are eating too much”
- Overly simplistic messages, e.g. “You just need to eat less and exercise more”
- Judgemental things.
Do say:
- Things like “person with obesity”, rather than “obese person”
- “Above ideal weight” or “outside a healthy weight range”
- Things which focus on moving towards a “healthy and happy way of life”
Make positive assumptions
You can ask “What do you do to keep healthy?”, to get an understanding of their lifestyle and of the positive actions they currently take.
If they talk about a lifestyle issue, use positive and empowering language to begin a plan to take action.
You could say:
- “Thanks for sharing what you do now, would it be helpful to talk about some support?”
- “It sounds like you are worried about your weight, could I give you some information?”
- “What do you think are the best next steps? How can I help?”
- “That sounds really tough, but it’s great you want to move towards a healthier way of life.”
- “By looking at this now, we can begin to make some small changes which will make a big difference”
This approach can help you talk about goal setting with the patient. You can ask questions about their targets and when they’d like to achieve them.
This can help you and the patient set SMART goals together. These are Specific, Measurable, Achievable, Realistic and Time-based.
Also focus on the positives of small changes. For example, weight loss of five per cent each year can be achievable and maintainable. More manageable goals can make your patient feel like change is possible, rather than overwhelming them with a daunting target.
Offer further support
A good, comfortable conversation will enable your patients to get the support they need to move towards a heathier, happier life.
And that’s where our team come in. Our experts are here to support patients to develop healthier habits relating to food, smoking and general wellbeing.
We help people set and achieve goals that will last a lifetime, we don’t just offer a quick fix.
Here are a few examples of language you might want to use to refer them to our services:
- “Can I tell you about a local service I think would be right for you?
- “I can get one of the team to give you a call and explain the programme, if that would be helpful?”
- “Would you like to do a referral together now? It’s quick and easy.”
- “I have worked with patients that have used this service and they found it really useful.”
We’re here to give your patients a nudge in the right direction, refer them to Be Well Walsall today.
