Conversations about weight loss can contribute tremendously to behavioral changes, but tangible examples may be even more effective. Place a few 5-lb bags of sugar in the patient’s lap so the individual can actually feel how much extra weight he or she is carrying. The sensation of 25 lbs in their lap will surprise many with regard to how much extra stress the weight has on their body, especially on the bones and joints of the legs. — Deana Goldin, DNP, ARNP, FNP-BC, Miami, submitted via the web (165-5)

These are letters from practitioners around the country who want to share their clinical problems and successes, observations and pearls with their colleagues. We invite you to participate. If you have a clinical pearl, submit it, here.