I can see that end of the problem, and I guess it wasn't what I was thinking about. But, in some ways, my brain breaks this example down into two seaparate but connected issues. There are thin patients with knee pain who *do* have to be more sedentary to reduce the load- elderly individuals with severe arthritis, for instance. And being 300 lbs is a big problem even if a person's knees are ok.
I think your idea of "shed a few pounds" is a good one. Even something like referring to "loosing fat" rather than "loosing weight" would be good. I'm thinking of elderly patients again, now- I've seen some who are *delighted* to loose weight, but don't seem to connect it with the fact that they're getting weaker because of muscle atrophy.
I'd probably want to go with something like: "I think your knees would improve if they didn't have so much strain on them. If you could get in a bit better shape, that would make a big difference." Which, yes, in some sense avoids the core issue of loosing weight. I'm not sure there's a great solution.
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I think your idea of "shed a few pounds" is a good one. Even something like referring to "loosing fat" rather than "loosing weight" would be good. I'm thinking of elderly patients again, now- I've seen some who are *delighted* to loose weight, but don't seem to connect it with the fact that they're getting weaker because of muscle atrophy.
I'd probably want to go with something like: "I think your knees would improve if they didn't have so much strain on them. If you could get in a bit better shape, that would make a big difference." Which, yes, in some sense avoids the core issue of loosing weight. I'm not sure there's a great solution.