Objective. We sought to identify any correlations among primary care provider weight screening and counseling, patient weight perception, and weight loss attempt. Methods. We performed a cross-sectional analysis of obesity-related questions from 2009 and 2010 Kentucky Medicaid Adult Patient and Provider survey data. Results. 1,510 patients [46% obese (body mass index (BMI) ≥30 kg/m2), 26% overweight (BMI 25 to <30), 26% normal weight (BMI 18 to <25), and 2% underweight (BMI<18)] and 787 providers (41% primary care) met criteria. Patients and providers differed on report of physician weight loss counseling (46% versus 92%). Patient report of physician weight loss counseling and weight loss attempt were positively correlated (77% with versus 38% without counseling, p<.01). One-fifth of patients underperceived their weight. Patients reporting physician weight counseling were less likely to underperceive their weight (13% versus 23%, p<.0001). Conclusions. Weight loss attempt and accurate weight perception were positively correlated with physician weight discussion.