Addressing Negative Thoughts in Your Patients Seeking Obesity Treatment

Weight Management
Raising the Bar:  Improving Care for Patients with Obesity: Creating Opportunities for Productive Clinician-Patient Interactions During a Pandemic
0.50 AMA PRA Category 1 Credit(s) 0.50 AAFP Prescribed Credit(s) 0.50 CA-BRN Credit(s)
Launch Date:
December 15, 2020
Expiration Date:
The accreditation for this activity has expired.

Primary Audience:

Family medicine physicians and other clinicians treating patients with obesity.

Relevant Terms:

Suzanne Mitchell, MD, MS

Associate Professor, Family Medicine and Palliative Care
Boston Medical Center
Boston University School of Medicine

Suzanne Mitchell is an expert in clinical delivery system solutions to improve chronic disease management and care transitions for patients and family caregivers navigating the healthcare system. She is a practicing, board certified palliative care provider and family physician, health services researcher, and medical educator with expertise in primary care redesign, care transitions and palliative care for underserved populations. Suzanne is a member of the Project RED – Re-Engineered Discharge research team at Boston Medical Center and a key contributor for Project ACHIEVE – a national study of patient and caregiver perspectives on care transitions. Suzanne’s other current research in care transitions is a 5-year study of mental health support for patients with acute illness and depressive symptoms using telephonic cognitive behavior therapy to reduce avoidable readmissions.

Suzanne is also an innovator, studying the use of virtual reality and other pioneering technologies to improve access to patient center care and enhance consumer empowerment. She is currently the lead investigator of an NIH clinical trial studying the use of social gaming technology for chronic disease self-management education. Suzanne is an associate professor at the Boston University School of Medicine and medical director for ambulatory palliative care at Boston Medical Center. She also maintains clinical responsibilities in palliative / hospice care at the Boston Medical Center Cancer Center. Her informed and practical point-of-view as a researcher, teacher and clinician makes Suzanne a sought-after trainer in health communications topics including team-based care, motivational interviewing, cross-cultural care, and shared decision making. Suzanne earned her MD from the Bowman Gray School of Medicine at Wake Forest University and completed her residency in family medicine at the Adventist Health System/White Memorial Medical Center in Los Angeles CA. She received her master’s degree in clinical research from the University of California Los Angeles. Suzanne likes to bike ride with her husband and son, enjoys blues and jazz at the local café, and takes long walks along the working waterfront in her hometown of Beverly, Massachusetts.

Paula Gardiner, MD

Associate Professor and Associate Director of Research
Family Medicine and Community Health 
University of Massachusetts Medical School

Paula Gardiner, MD received her medical degree from the Tuft University Medical School and completed her residency in Family Medicine at Tuft University Medical School. In addition to completing her MPH from the Harvard School of Public Health, she also completed a three-year Clinical Research Fellowship in Complementary and Alternative Medicine Research and Faculty Development at Harvard Medical School. Dr. Gardner was awarded an NIH K award focusing on Integrative Medicine, technology, and health disparities.

Her research concentration is patient-oriented research regarding chronic pain and evidence-based integrative medicine access in low income patients. Current research is focused on the adaptive role of an Integrative Medicine Group Visit (IMGV) combining mindfulness-based stress reduction and a medical group visit to support health behavior change and reducing pain and stress. Dr. Gardiner is leading the implementation of this medical group visit model nationally and provides training on medical group visits around the United States.

With PCORI funding, she is also the PI on a RCT of IMGV compared to a primary care visit for participants with chronic pain. She also has an interest in clinician stress and resiliency. As a researcher in mindfulness, she became a certified meditation teacher and has led Mindful-based Stress Reduction (MBSR) classes. Dr. Gardiner has published over 90 peer-reviewed papers on chronic pain, technology, dietary supplements, pregnancy, preconception care, stress, and integrative medicine in underserved patients.
1. Recognize negative thoughts by patients seeking obesity treatment
2. Use reframing reflections to help patients manage negative self-talk
3. Incorporate a CBT strategy for addressing negative thoughts by patients seeking obesity treatment
4. Expand their understanding regarding obesity's impact on diabetes


This activity is designed for family medicine physicians and other clinicians treating patients with obesity.

Accreditation statement:

The California Academy of Family Physicians is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. 
The California Academy of Family Physicians designates this educational activity for a maximum of 0.50 AMA PRA Category 1 Credit.™ Physicians should only claim credit commensurate with the extent of their participation in the activity.
CAFP is certified as a continuing education provider (number 1809) by the California Board of Registered Nursing. This certificate must be retained by the licensee for a period of four years after the conclusion of the course.

Raising the Bar:  Improving Care for Patients with Obesity: Creating Opportunities for Productive Clinician-Patient Interactions During a Pandemic has been reviewed and is acceptable for up to 0.50 Prescribed credits by the American Academy of Family Physicians. AAFP accreditation begins 12/15/20. Accreditation expires 03/01/22. 


The California Academy of Family Physicians' (CAFP) Committee on Continuing Professional Development is responsible for identification, management and resolution of conflict for any individual who may have the potential to influence content, who have served as faculty, or who may produce CME/CPD content for the CAFP.  Management/Resolution may include learner notification, peer review of content before presentation, requirement of EB-CME, changing topics, or even dismissing a potential planning or faculty member.

It is the policy of the CAFP to ensure independence, balance, objectivity, scientific rigor, and integrity in all their continuing education activities. All individuals with potential conflicts are contacted by CAFP staff or CCPD members, and issues of conflict have been discussed, managed, and resolved.  All individuals with potential to influence the content of this program have submitted Conflict of Interest declarations that have been reviewed according to policy. All disclosures were made for work beginning January 1, 2020 and have been resubmitted and renewed annually.  CAFP reviewed conflict of interest statements for each individual with potential to influence content and everyone in a position to influence content stated that neither he/she and/or his/her spouse/partner had any relevant financial interests to disclose.



Suzanne Mitchell, MD declares that in the past 12 months neither she nor her partner/spouse have a financial interest/arrangement or affiliation with one or more organizations that could be perceived as a real or apparent conflict of interest in the context of the subject of this continuing education activity.

Paula Gardiner, MD declares that in the past 12 months neither she nor her partner/spouse have a financial interest/arrangement or affiliation with one or more organizations that could be perceived as a real or apparent conflict of interest in the context of the subject of this continuing education activity.

Jerri L. Davis, CHCP, CAFP Director of Continuing Professional Development and CME, declares that in the past 12 months neither she nor her partner/spouse have a financial interest/arrangement or affiliation with one or more organizations that could be perceived as a real or apparent conflict of interest in the context of the subject of this continuing education activity.

Instructions for Participation and Credit

Learners must register to participate in and receive credit for this online educational activity. For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.

This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit™ and AAFP Prescribed Credit, you must receive a minimum score of 65 percent on the post-test. Upon successful completion of the post-test, the learner will receive a certificate of participation that can be used to claim CME credit.

Steps to Earn CME/CE credit

Read the target audience, learning objectives, and author disclosures. Study the educational content online or printed out. Online, choose the best answer to each post-test question. To receive a certificate, you must receive a passing score as designated at the top of the test and complete the Activity Evaluation.

Your certificate will be emailed to the address you provided when registering. You may print the certificate, but you cannot alter it.



For questions regarding the content of this activity or for technical assistance, contact

The CAFP has made all reasonable efforts to ensure that information contained herein is accurate in accordance with the latest available scientific knowledge at the time of accreditation of this continuing education program. Information regarding drugs (e.g., their administration, dosages, contraindications, adverse reactions, interactions, special warnings, and precautions) and drug delivery systems is subject to change, however, and the learner is advised to check the manufacturer's package insert for information concerning recommended dosage and potential problems or cautions prior to dispensing or administering the drug or using the drug delivery systems.

Approval of credit for this continuing education program does not imply endorsement by CAFP of any product or manufacturer identified.

Any medications or treatment methods suggested in this CME activity should not be used by the practitioner without evaluation of their patient's condition(s) and possible contraindication(s) or danger(s) of use of any specific medication.



This initiative is supported by an unrestricted educational grant from Novo Nordisk.



Obesity is a wide-spread, costly, and chronic public health issue in the United States. More than one-third (39 percent) of U.S. adults (18 years of age and older) have obesity, defined as having a body mass index (BMI) of 30.0 or higher. Currently, obesity related healthcare costs are estimated to be from $147 billion to $210 billion annually. Obesity is linked to a number of chronic medical conditions including diabetes, heart disease, certain cancers, and arthritis.  Obesity is also a risk factor for gestational diabetes which is a risk factor and often a precursor to developing type 2 diabetes for women in middle and later life.

Unfortunately, healthcare providers (HCPs) tend not to effectively communicate the diagnosis of obesity, its nature as a serious and chronic disease, the full range of treatment options, and obesity's implications for health and quality of life. They also miss the opportunity to engage in more effective conversations by better appreciating their patients' motivation and treatment goals. (Look, 2019)

Ref: Look M, Kolotkin RL, Dhurandhar NV, Nadglowski J, Stevenin B, Golden A. Implications of differing attitudes and experiences between providers and persons with obesity: results of the national ACTION study. Postgrad Med. 2019;131(5):357-365.



There is no charge for this activity.


This activity will not include discussions of products or devices that are not currently approved for use by the Food and Drug Administration (FDA), and the curriculum clearly indicates this fact.


CAFP policy and California state law requires that each learning activity including a patient care element address the topic of cultural and linguistic competency. This activity meets this requirement.

Equitable and Inclusive Curriculum

CAFP requests all faculty to present content that uses inclusive language to guide care for all our diverse patients.



The California Academy of Family Physicians (CAFP) is committed to protecting the privacy of its members and customers. CAFP maintains safeguards to store and secure information it has about members and customers. The safeguards may be physical, electronic or procedural. For more information, go to 


© 2020 California Academy of Family Physicians. All rights reserved. No part of this activity may be used or reproduced in any manner whatsoever without written permission except in the case of brief quotations embedded in articles or reviews.


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