Being overweight carries with it a range of health risks, including high blood pressure, heart disease, diabetes, sleep apnoea, musculoskeletal problems and cancer. Weight is often a highly charged emotional subject, but it is one health professionals increasingly need to raise with patients. The conversation should explore how patients feel about their weight, their understanding of how weight may affect their health, their emotional and mental wellbeing, what they may have tried to do about their weight and how committed they are to making lifestyle changes. By recognising that past experiences and struggles with weight and failure to succeed have a profound effect on commitment, health professionals can begin to have helpful conversations about weight management and behaviour change.