[Lifestyle change? No excuse!]

Obesity is a chronic disease affecting nearly one-third of the adult population of Hungary, which, as a risk factor for other chronic diseases, worsens somatic and mental health, quality of life and life prospects. All evidence-based weight loss therapies are based on lifestyle modification, which minimally require limiting energy intake and increasing physical activity. However, in the vast majority of cases, patients are reluctant to change their lifestyle, expressing concerns about it (e.g., “I’m gaining weight just by breathing!”, “I can’t stand sports!”, “I don’t want to starve!”). It is common for doctors to interpret these fears as “excuses”. On the one hand, this interpretation creates anger towards patients, on the other hand, it prevents active listening and the expression of empathy, so the factors behind the resistance are not explored and solved. As a result, the specialist is either unable to involve the patient in the therapy, or if he/she does, the adherence falls short of expectations, impairing the effectiveness of the treatment. Indoctrinating or even condemning the patient worsens the doctor-patient relationship and can lead to avoidance of the health care system, which can aggravate the degree of excess weight as well as the course of comorbid diseases. The purpose of this study is to show how it is worth responding to patients’ expressions of reluctance, and what communication strategies can be used to facilitate successful involvement in weight loss treatment and the strengthening of commitment to lifestyle change, providing tools for the gradual elimination of health-damaging habits and for the development of health-protecting habits in favor of the long-term sustainable, effective, healthy body weight control. Orv Hetil. 2024; 165(19): 727–733.