It is obvious that doctors recognize obesity as a health problem. So why is it so hard for them to talk to their patients about it? The results of two surveys, one of primary care physicians and the other of patients, found that while most doctors want to help patients lose weight and think it is their responsibility to do so, they often don't know what to say. "So while doctors may tell patients they are overweight, the conversation often ends there," said Christine C. Ferguson, director of the _ . "Patients are not told about the possibility of diabetes  ," she said. "And doctors don't feel they have good information to give. They felt that they didn't have adequate tools to address this problem. The lack of dialogue hurts patients, too. The patient survey, of over 1,000 adults, found that most overweight patients don't even know that they're too heavy. Only 39 percent of overweight people surveyed had ever been told by a health care provider that they were overweight. Of those who were told they were obese, 90 percent were also told by their doctors to lose weight, the survey found. In fact most have tried to lose weight and may have been successful in the past--and many are still trying, the survey found. And many understand that losing even a small amount of weight can have a positive impact on their health and reduce their risk of obesityrelated diseases like hypertension and diabetes. Dr. William Bestermann Jr., medical director of Holston Medical Group, in Kingsport, Tenn. , which ranks the 10th in obesity among metropolitan areas in the United States, said the dialogue had to be an ongoing one and could not be dropped after just one mention of the problem. "If you're to be successful with helping your patients lose weight, you have to talk to them at actually every visit about their progress, and find something to encourage them and coach them," he said. He acknowledged that many doctors tend to be not optimistic. "Part of this is that there's this common belief, and doctors are burdened by it, too, that overweight people are weak-willed and just don't have any willpower and are selfindulgent and all that business," he said. "If you think that way, you're not going to spend time having a productive conversation." According to the passage, which factor contributes to the lack of dialogue between doctors and patients?
Most doctors never think of warning their patients about their weight problem. Many doctors find it difficult to persuade overweight people to lose weight. Most patients are too weak-willed to do anything about their weight. Many patients tend not to trust their doctors about their weight problem.