Smoking Cessation and Weight Management

How I Practice Video Series
Mark S. DeFrancesco, MD, MBA, FACOG

HIP: Smoking Cessation and Weight Management from ACOG on Vimeo.


The reality is so many of our patients, particularly in the 18-55 age group, see only us primarily as their physician. The reality also is that many of our patients engage in unhealthy behavior or have unhealthy conditions, particularly smoking and obesity. And the reality also is that if we can intervene especially early in patient’s lives in both of these conditions we can have a tremendous impact on the health status of our nation. So that’s why at every single annual visit I inquire of every patient about her smoking status and I make sure that every patient knows her BMI before she leaves the office. For smokers, I encourage them to stop smoking. I tell them I know how hard it is to stop smoking, but I tell them that they can do it. I help them strategize about how to reduce and eliminate the number of cigarettes they smoke and I help them actually calculate the dollars that they would save on an annual basis if they stopped smoking and that’s an eye-opening experience. And finally I remind them that if they don’t smoke, there’s an excellent chance their kids won’t smoke too and that’s a tremendous motivator for many patients to make sure their kids don’t start smoking.

For my patients who are more on the overweight side, first of all I tell them that they are. Many patients really appreciate that and they tell me that really they thank me for my honesty and they tell me that many of their other doctors have never approached them with this directly even though they kind of know that they’re overweight. So we talk about choice of food, we talk about activity and exercise, we talk about healthy choices. Ultimately we also discuss local resources, whether its Curves, Weight Watchers, other nutrionists in the area. I even offer the patients the opportunity to go on their own weight loss program with some of the advice that I’ve given them and I will even monitor them if they want to come back on a regular basis to be weighed in to check their progress. All of these things are difficult, smoking and obesity are difficult sometimes to bring up with patients, but I can assure you if you do a. it won’t take as much time as you might imagine and the more you do it, the better you get at it and b. your patients will not only appreciate it but you’ll make a difference for many of them. This is how I practice.


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