PRECISION BITES: TALKING WITH PATIENTS ABOUT WEIGHT MANAGEMENT

A podcast of simulated clinic encounters dealing with motivational interviewing and weight management in different social contexts. 

Episode 1: Talking with the Obese Child and Mom

A provider talks with Alex, a 12 year old boy and his mom. Alex’s BMI has been in the 95th percentile for a couple visits now, so the provider called him back in for a follow up appointment. Of note, the whole family sees the provider, and all members of the family are obese.

Episode 2: Talking with the Opioid Dependent Patient

Today the provider will see a 65 year old female with chronic back pain and history of opioid dependence, treated with methadone for 1 year, treatment complicated by 20 lbs weight gain in the last year. The patient’s co-morbidities are chronic back pain and opioid dependence. She lives alone and is on disability.

Things we want you to take away from this episode include: 

  1. How chronic pain, opioid dependence, and weight interact. 
  2. How to set the agenda for a visit with patients with these issues.
  3. Common supports and resources for weight management for this patient.

Episode 3: Talking With The Resource Poor Patient

Today the provider will see a 45 year old white mother with hypertension, hyperlipidemia, fatty liver disease, BMI 34, presenting for initial weight consultation. She is resource poor, works two jobs, and has 2 young children. Her husband has not been able to find work since the recession.

Things we want you to take away from this episode include: 

  1. How food insecurity, hunger, and weight interact
  2. Diet strategies for the resource-poor and busy patient

Episode 4: Talking with the Patient with Multiple Prior Attempts to Lose Weight

Today the provider will see a 28 year old South Asian male with high health literacy. He is frustrated because his BMI in college was 25, and despite multiple attempts to lose weight, his BMI has crept up to 32 today. He has a well paying job in the tech industry, and lives alone.

Things we want you to take away from this episode include:

  1. How to approach the frustrated patient
  2. How social networks can affect weight loss
  3. How to inspire small, consistent changes in your patients

Episode 5: Talking with the Patient Who Doesn't Know Why

Today the provider will see a 40 year old male presenting for a follow-up after a recent hospitalization for biliary colic. A cholecystectomy was not performed.

Things we want you to take away from this encounter include: 

  1. How to develop the patient’s awareness of the discrepancies between his or her perception and health outcomes
  2. How to ask advanced diet history questions

Episode 6: Talking with the Hispanic Patient

Today the provider will see an obese 45 year old Puerto Rican woman who is part of a combined family, newly diagnosed with pre-diabetes.

Things we want you to take away from this encounter include: 

  1. How to assess the medical family history with ethnicity in mind
  2. How to introduce changes to diet without placing blame or offending family members
  3. How to offer culturally aware and appropriate food substitutions

Episode 7: Talking with the Asian Patient

Today the provider will see a 50 year old Chinese-American male, part of a combined family, newly diagnosed with pre-diabetes.

Things we want you to take away from this encounter include: 

  1. How to assess the medical family history with ethnicity in mind
  2. How to introduce changes to diet without placing blame or offending family members
  3. How to offer culturally aware and appropriate food substitutions

Episode 8: Talking with the Homeless Patient

Today the provider will see 33 year old male with mild cognitive impairment, unspecified mental illness, homeless, and a BMI of 17 presenting for initial weight consultation. He is plugged into public assistance services such as CalFresh. He also has a regular mental health team that he sees.

Things we want you to take away from this encounter include:

  1. How to gather and interpret information about where homeless patients obtain food
  2. How to instruct homeless patients about food storage and preparation
  3. How to offer anticipatory guidance about nutrition to your homeless patients

Episode 9: Talking with the Busy Patient

Today, the provider will be talking with a 38 year old woman with a BMI of 30. She is a lawyer and works full time. As a single mother of two pre-teen boys, she is incredibly busy balancing work and her family.

Things we want you to take away from this encounter include: 

  1. How to ask about a patient’s motivations and barriers to action
  2. Examples of behavior modification for busy patients