Initial patient engagement by cardiologists must be handled with discretion, sensitivity, and non-judgmental communication to avoid reinforcing stigma and alienation, which negatively impact quality of care.

In clinical practice, every first ‘contact’ with a patient, regardless of the clinical setting—whether during hospitalization or an outpatient visit—should be seen as an opportunity to initiate a personalized therapeutic journey. The first key principle outlined in the guidelines is that not all patients living with obesity are ready to address this issue with their physician. Therefore, discretion, sensitivity, and tact are required during this initial engagement, offering help in a respectful and open-minded manner.