Finding the right way to have conversations about healthy lifestyle concerns, including obesity, smoking and alcohol consumption, with your patient can be difficult to navigate. There are a variety of routes you can follow, and some are more effective than others.
What commonly gets in the way of having these conversations is a lack of time, uncertainty about what language to use, or fear of upsetting the individual.
What you say and how you say it can make a huge difference for your patient. Some carefully chosen words can be just the right nudge a person needs to begin to take action towards a healthier and happier way of life.
Research shows that well planned, short-term interventions can increase the chances of a patient making a successful change in their lifestyle. Public Health England, demonstrate this in their useful guide ‘Let’s Talk About Weight’.
Ultimately the earlier you open the conversation and offer support, the easier it will be for your patient to move towards creating healthier lifestyle habits. The fear of having the conversation is often worse than the reality, in fact, in our experience, many people welcome the support.
Below you’ll find tips on how to have difficult conversations, which include some examples of phrases you could use, and some to avoid.
Understanding the stigma
Before you have a conversation with your patient, it‘s important to understand the stigma surrounding their condition, whether it is weight, smoking or alcohol consumption.
Nature Medicine on World Obesity Day 2020, published a paper that included an international consensus statement on ending the stigma of obesity.
Part of this included how people living with obesity face the social stigma that their bodies are a result of a lack of self-discipline and personal responsibility.
This can be backed up by further evidence from the All-Party Parliamentary Group on Obesity. They published a report which stated that 94% of respondents believe there is not enough understanding about the cause of obesity amongst the public, politicians and other stakeholders.
The causes of obesity are complex and commonly misunderstood by the majority. Factors include an individual’s biology, psychology, environment, and financial situation. As well as societal and cultural influences, such as the production, availability and consumption habits of unhealthy foods or substances.
This stigma can be internalised, which can create negative repercussions for people’s physical and mental well-being. They may feel discouraged from making positive changes to their lifestyle or avoid seeking preventive care.
But there’s a possibility that difficult conversations with you about healthy lifestyles could make a difference.
Listen and approach difficult healthy lifestyle conversations with empathy
Remember, behind all the data and research, you’re dealing with a person with their own story. Before and during your conversation, try to understand how your patient will be feeling. Don’t make assumptions about their health on their behalf, instead try to understand their point of view.
You could start by asking open questions, and allow them the opportunity to speak openly first. Practice active listening, by understanding what they have said, reflecting and responding.
You could use phrases like:
- Sounds like…
- I can hear that…
- I can see by the expression on your face that…
Showing that you have heard and understood what they are saying is a critical first step before touching on potential sensitive subjects.
How do they describe their weight and body image or alcohol consumption? If you’re unsure of a meaning behind one of the words – ask them about it and try not to correct them if you think they misspoke. Focusing on the meaning of words used to describe their lifestyle choices can help you explore any internal bias your patient might have.
It’s important to know what matters most to your patient. You should be aware of their goals and what they would like to achieve, rather than focus on what you think they should do.
Ask permission
Someone may raise concerns about their lifestyle, and you can use this as a starting point. However, if they don’t bring it up themselves, it’s important that you ask for permission first.
You could do this by directly asking “Is it ok if I ask you about smoking?”
Or approach the topic indirectly and ask,
- “Do you have any concerns about your health 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?
- “For some people, the things you have raised (i.e. not wanting to be active, always hungry etc.) can sometimes lead to being above a healthy weight. Is that something you are concerned about?”
If you see this patient regularly and use these broad openers frequently, make sure to modify your language to avoid repetition.
Language matters
It’s worth looking at what kind of language you are using during these difficult healthy lifestyle conversations. Remember, your language is not only about your words, but your tone and gestures too.
Language to avoid:
- Negative consequences e.g. “’If you don’t lose weight, you will get diabetes.”
- Blaming or shaming language e.g. “You are eating too much.”
- Overly simplistic language e.g. “you just need to eat less and exercise more.”
- Judgemental language and humour.
Language to use:
- Person-first language e.g. “person with obesity” rather than an obese person
- “Above ideal weight” / “outside a healthy weight range”
- Focus on moving towards a “healthy and happy way of life.”
Make positive assumptions
Understanding that your patient may have previously felt stigmatised, means that you can focus on making positive assumptions rather than negative.
You can ask “What things do you do to keep healthy?”, to get an understanding of their lifestyle and what positive actions they currently take.
If they open up about their weight, alcohol consumption or smoking, it’s helpful to use positive and empowering language to begin to create a plan together with them to take action.
A few examples of language you could use here include:
- “Thanks so much for sharing where you are at right now – would it be helpful to talk about some support?”
- “So, it sounds like you are a bit worried about your weight – would it be useful if I gave you some information?”
- “What do you think are the best next steps? How can I help?”
- “That sounds really tough. It’s great you want to move towards a healthier way of life.”
- “The good thing is by looking at this now we can begin to make some small changes that will make a big difference.”
This approach can help you talk about goal setting with the patient. You can ask questions like, “What are your targets and when would you like to achieve them?” This can help you and the patient set SMART goals together. These are Specific, Measurable, Achievable, Realistic and Time-based.
It can also be good to focus on the positives of making small changes. For instance, weight loss of 5% per year can be achievable and maintainable. More manageable goals can make your patient feel like change is possible, rather than overwhelming them with a seemingly impossible target.
Offer further support
Having a comfortable conversation with your patient will ultimately enable them to get the support they need to take action towards a healthier and happier life.
That’s where our team come in. Our expert teams are here to support patients to develop healthier habits relating to food, smoking and alcohol. 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 can use to refer to our services:
- “Can I tell you about a local service that I think would really support 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.”
Remember, conversations about a healthy lifestyle can be difficult but they’re incredibly important.
We’re here to help you and your patients. If you know someone who needs a nudge in the right direction, refer them to Be Healthy Bucks today.
