Strategies for Providing Optimal Care to Overweight Patients

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Health care providers can take steps to overcome barriers to ensure optimal medical care of patients who are obese. Optimal care begins with educating staff about treating patients with respect. Having appropriate equipment and supplies on hand further increases patient access to care. Weighing patients privately and only when necessary may help overcome their reluctance to seek out medical services. Offering preventive services, in addition to monitoring and treating ongoing medical conditions, helps ensure that obese patients receive the same level of care as non-obese patients. Finally, providers should encourage healthy behaviors and self-acceptance even in the absence of weight loss.

Using the following checklist can improve patient care in your office.

Create an accessible and comfortable office environment.

• Provide sturdy, armless chairs and high, firm sofas in waiting rooms.
• Provide sturdy, wide examination tables that are bolted to the floor to prevent tipping.
• Provide extra-large examination gowns.

Use medical equipment that can accurately assess patients who are obese.

• Use large adult blood pressure cuffs or thigh cuffs on patients with an upper-arm circumference greater than 34 cm.
• Have a weight scale with adequate capacity (greater than 350 pounds) for obese patients.

Reduce patient fears about weight.

• Weigh patients only when medically appropriate.
• Weigh patients in a private area.
• Record weight without comments.
• Ask patients if they wish to discuss their weight or health.
• Avoid using the term obesity. Your patients may be more comfortable with terms such as "difficulties with weight" or "being overweight."

Encourage healthy behaviors.

• Discuss weight loss—as little as 5 to 10 percent of body weight—as a treatment for weight-related medical conditions.
• Emphasize healthy behaviors to prevent further weight gain, whether or not the patient is able or willing to lose weight.
• Encourage physical activity to improve cardiovascular health.
• Seek out professional resources to assist your patients and provide referrals to registered dietitians, certified diabetes educators, exercise physiologists, weight management programs, and support groups, as appropriate.
• Promote self-acceptance and encourage patients to lead a full and active life.

Providing optimal medical care to patients who are obese may be challenging. Changes that foster a supportive and accessible environment for the patient, however, are within reach of most health care providers and can go far to overcome both patient and provider barriers to care.