Why are we afraid to talk to our pt's about their weight? It's time we treat their obesity as the disease condition it is, and educate them about the consequences of it: sleep apnea, diabetes, heart disease and osteoarthritis to name a few. It's obvious that many physicians are uncomfortable with this topic as well. I've cared for many pt's who were oblivious to the fact that their 300 lb. weight was the reason they were having a knee replacement at 40 y.o. and that they could likely improve the pain by losing weight. We are doing them a disservice by not talking to them about their weight.