My grandmother was both ahead of her time and a product of her time. Ahead of her time in the sense that she was a microbiologist. A product of her time in that she was a lifelong smoker. She had no medical problems despite being a consistent half-pack-a-day smoker.

By the time she reached her late 70s, her longtime primary care doctor retired, and she entered into a relationship with a new primary care doctor. After her first appointment, she called me upset. Her new doctor had told her to stop smoking. At first I had to laugh, but I saw her point: She was approaching her 80th birthday with zero medical problems, and he wanted to pick on her for her more than half-century smoking habit?

Yet it was not only important, but vital that he talked to her about kicking the habit. About three years later, she was diagnosed with lung cancer. What if her new doctor had not counseled her against smoking? How would he have felt knowing he had not done his part in trying to help her? Although she may not have avoided the cancer diagnosis, being smoke-free for years would have absolutely helped her during treatment.

So, let me ask you this: What kind of doctor do you think my grandmother's doctor would be had he not counseled her against smoking? What kind of doctor doesn't talk to patients about unhealthy, unsafe or dangerous habits? In my opinion, a bad one. One who places his or her own comfort over the health of patients. Having these discussions with patients can be difficult – and doctors know these can make you uncomfortable. But that does not mean these discussions are not important. They are. And the discomfort these discussions produce can be a good thing, because discomfort can spark change.

So let's pivot to another uncomfortable truth: Only 3 out of every 10 Americans are at a healthy weight. Depending on ethnicity and race, that number goes down to 2. This is not about appearance, clothing size or even how someone looks in a bathing suit. Your doctor, quite frankly, could care less. Here is what doctors do care about: 30-year-olds suffering heart attacks; patients needing liver transplants because their livers have become invaded by fat; complication rates that are 12 times higher in overweight patients needing surgery; the list goes on. These are not random facts thrown on paper in an attempt to shock or scare you. These patients are real. I should know: I have taken care of all of them.

Being overweight causes medical problems. But it also puts you at an increased risk for complications and physically hinders your doctor's ability to take care of you. Although medical tools and equipment are catching up to the obesity epidemic, the fact remains that their use is often limited by body size, and this, in turn, limits doctors' ability to care for obese patients.

And we, your doctors, are here to help you. We must have conversations with our patients about their weight. Not to make anyone feel ashamed or embarrassed or angry, but to paint a real picture of how being overweight affects a patient's health and the health care he or she is able to receive. Online doctor reviews coupled with accusations of fat shaming have all created an environment in which many doctors feel unable to have sensitive conversations about weight with their patients. But remember: You are not at lunch with friends or at work with colleagues. You are in a doctor's office, or clinic or hospital, having a confidential, professional conversation with your doctor. This is the last person with whom you want to avoid having health conversations. Your doctor needs to be able to have this conversation with you. Then you can move forward together toward better health.

Here are some tips on how to have a productive conversation with your doctor about weight:

Keep an Open Mind

Hear your doctor out, when the discussion turns to the numbers on the scale.

Ask Questions

Inquire about the specific health concerns your doctor has related to your weight. It will help you understand the why behind the conversation.

Set Goals

Discuss how much weight you need to lose, and over what time period. Then, discuss some realistic goals for you to try and achieve a healthy weight.

Formulate a Plan

Be upfront about what your unique challenges and temptations are. Review what resources are available to help you make smarter food choices and increase your activity levels.

Schedule a Follow-Up

It is awfully difficult to pick a goal, formulate a plan and stick with it on your own. Checking in with your doctor along the way gives you access to advice and an opportunity to see improvements beyond the scale – such as a lower cholesterol level or better blood pressure control. These improvements, in turn, will help keep you motivated!

So, the next time your doctor wants to talk to you about your weight, do not get mad, be glad. Be glad that your doctor cares enough about you, your health and your future to have that talk with you. It is not fat shaming. It is doctoring.

