The position of nurses in approaching discussions about weight and life-style

Sensitive communication and giving sufferers house to voice their considerations are key to managing weight problems – and nurses in major care are properly positioned to do each, in keeping with a senior weight problems specialist nurse.

While nurses play a significant position in offering well being schooling and supporting profitable life-style modifications, it may be difficult to broach the topic of weight with sufferers.

Speaking at a Nursing in Practice 365 virtual event on 11 February 2026, Wendie Smith, a sophisticated nurse practitioner, and senior weight problems specialist nurse, supplied lots of of nurses sensible recommendation on the best way to do precisely that.

‘Nurses play a crucial role in addressing obesity,’ mentioned Ms Smith. But doing so successfully requires delicate communication, a real understanding of sufferers’ particular person circumstances, and consciousness of the cultural and private limitations that may form a affected person’s relationship with their weight.

Ms Smith’s speak coated the sensible software of NICE steering for weight administration, the constraints of BMI, the best way to increase weight sensitively in scientific consultations utilizing the “Three A’s” framework (ask, advise, help), and the significance of empathetic, non-judgmental communication with sufferers. Moreover, there was a specific emphasis positioned on managing weight within the context of kind 2 diabetes.

Ms Smith highlighted that weight problems is the one most vital threat issue for creating kind 2 diabetes throughout all age teams. Given that almost two-thirds of UK adults at the moment are obese or dwelling with weight problems, the dimensions of the problem going through healthcare professionals continues to extend.

Despite this, multiple clinical studies have demonstrated that sustained weight reduction – even simply 5–10% – can enhance blood glucose ranges, enhance insulin motion, and scale back the necessity for diabetes drugs.

Language and stigma

Ms Smith emphasised that language and communication approaches matter enormously when speaking about weight.

She inspired nurses to: ‘Provide support, communicate with empathy, [and] respect patients’ selections – and that’s key in managing weight problems, as a result of it’s a very, very tough topic for some individuals.’

Nurses have been additionally suggested to be ‘understanding of patients who may be reluctant to be measured or find discussion about weight triggering’, however to additionally attempt to present sufferers with the instruments and house to deal with any considerations.

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‘We do need to think about obesity as preventable and treatable, and that is really key here, whether we aim for 5% or 10% weight loss, what we need to be doing is encouraging our patients to consider it, because actually addressing it can open the door,’ mentioned Ms Smith.

‘We also have to understand that support is needed to address this, what we need to do is give people the tools, give people the space to address their concerns about their weight, and actually give them the information about how weight can impact on their future and current health.’

Nurses have been additionally urged to think about the language they used throughout conversations about weight and weight problems.

‘I wouldn’t need to be known as overweight or weight challenged. So, the language we use is de facto key,’ she mentioned.

Language frames the session, she added, and it’s important that folks don’t really feel focused in any method.

The European Association for the Study of Obesity advocate utilizing person-first, non-judgemental, and non-stigmatising language. For instance, ‘person with obesity’ fairly than ‘obese person’.

It says, person-first language avoids labelling individuals by their sickness and defining an individual’s identification by their well being situation.

Alternatively, NICE suggests well being professionals determine and discover the phrases the affected person would like.

Ms Smith added: ‘What is really key, is we need to be aware of our own stigma attached to obesity. I think as practitioners, we set the tone here.’

‘Ask, Advise and Assist’

During her speak, Ms Smith highlighted the ‘Ask, Advise, and Assist’ method as a way that she finds useful for opening a dialog about weight with sufferers.

The technique, additionally known as the ‘three A’s framework’, was really useful by Public Health England (now below the UKHSA and DHSC).

The three-step method is as follows:

• Ask permission to debate weight, being non-judgemental and exploring the affected person’s readiness for change. Simple inquiries to provoke the dialog could be: ‘Before you leave, could I check your weight today?’; or ‘While you’re right here, can I examine your weight?’ If they agree, you may measure the individual’s peak, weight and waist circumference, to find out their weight problems stage.
• Advise on the advantages of modest weight reduction, and the way this may be extra achievable with assist. Explain what particular providers can be found to them and supply referral. Try to maintain this transient, to round 30 seconds to keep away from lecturing. For instance, ‘One of the best ways to lose weight is with support and [named local weight management service] is available free. I can refer you now if you want to give it a go?’
• Assist the affected person to decide to motion and go away with a plan in place, by making a referral to the service you could have agreed on and providing ongoing assist. If they’re receptive, you may allow them to know the subsequent steps – for instance, ‘I will refer you to the service now. You’ll get an appointment by the publish’ – and counsel a follow-up appointment – for instance, ‘I’d wish to see the way you’re getting on, so subsequent time you come to see me, I’ll weigh you once more and we are able to speak some extra’.

However, Ms Smith famous that if the affected person is non-committal, or doesn’t need to interact in any respect, settle for their needs and acknowledge their considerations but additionally re-offer assist for a future time.

Alternatively, Ms Smith mentioned nurses may ask sufferers what their weight was the final time they weighed themselves, or whether or not they had scales at house that they may use to offer a measurement.

Whatever the result, nurses are reminded to make an observation within the affected person’s information in regards to the dialogue and what comply with up is required.

Other components to think about

‘Obesity is a complex condition with multi factorial causes,’ Ms Smith mentioned.  ‘Ethnicity and genetics play a role. And I think the most important thing is socioeconomic factors, because if we don’t have in mind how a lot individuals can spend and the way a lot individuals can earn, then truly we aren’t doing our job properly.’

Ms Smith highlighted that for nurses working in disadvantaged areas, it may be extraordinarily useful to concentrate on native assets – akin to cooking lessons, train programmes, and well being coaches – and tailor recommendation to what’s sensible for every affected person’s circumstances.

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NICE guidance urges practitioners to know the affected person’s life:

• Think about household historical past and weight-related issues.
• Be conscious of weight historical past (and for kids and younger individuals, progress historical past), and former experiences of associated issues (akin to consuming problems).
• Think about household and private context: day by day life, ethnicity, tradition, cash worries, particular wants and disabilities, psychological well being components and stage in life.

Ms Smith added: ‘It’s essential to know every individual’s potential causes and dangers and assist them to deal with it. I usually say, what beginning weight have been you. Or, how large are your loved ones? Are they tall? Are they quick? Because the genetics of which might be unchangeable, so now we have to acknowledge that.’

GLP-1 receptor agonists: not an alternative choice to assist

Towards the tip of her speak, Ms Smith acknowledged that injectable weight problems medicine akin to Wegovy and Mounjaro could also be altering the remedy panorama. However, she was clear that she believes that these drugs alone aren’t sufficient.

While GLP-1 receptor agonists are efficient at suppressing urge for food, they don’t handle the behaviours that drive weight acquire. Wraparound assist – together with dietary recommendation and behavior change programmes – stays important, and nurses are key to that, she mentioned.

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