In a survey of 471 patients, we collected self-reported weight and height data and asked about self-perceptions of provider support toward weight loss and other weight management concerns. Multivariable analysis found that respondents with higher body mass index (BMI) were more likely to report that a physician had told them that they were overweight (OR=3.49, 95% CI 2.06–5.89, P<0.001). However, this conversation was less likely to change their personal view of their weight (OR=0.62 per 5 kg/m2, 95% CI 0.45–0.86, P=0.004), or motivate them to lose weight (OR=0.67 per 5 kg/m2, 95% CI 0.50–0.91, P=0.009). Higher BMI was associated with higher weight-loss goals (P<0.001), while anticipated time to achieve those goals was increased (P<0.001). Physician involvement in weight management was important, but the patients’ needs and experiences differed by BMI. Approaches to addressing barriers and identifying resources for weight management should be tailored to individuals by considering BMI.