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New research from the Nuffield Department of Primary Care Health Sciences sets out evidence-based guidance to help clinicians have more effective and supportive conversations about weight loss with patients living with obesity.

GP shows a leaflet to female patient © Obesity Canada

In the new review, published in The Journal of the American Medical Association, the researchers looked at previous studies which have used specialist analysis of real doctor-patient interactions. By summarising the evidence available from these studies, the researchers were able to identify specific communication techniques that have been shown to support effective and well-received conversations about weight loss.  

They found that clinicians should aim to: 

  • Initiate communication about weight loss gently by softening their language, referencing a previous conversation about weight loss, or using meta-assessments such as ‘This might be an awkward conversation.... 

  • Tailor communication to what is relevant for the patient by referencing earlier conversations in the appointment, asking questions then tailoring responses, and accepting a patients’ response. 

  • Communicate positively and emphasize the benefits of weight loss by including optimistic projections of the future, explicitly positive words, and a positive tone. 

  • When possible, offer specific treatment, rather than advice only, clearly stating treatment options available, providing detail on where and how treatment can be accessed and any cost, and emphasizing the next step.  

Drawing on the specialist analysis of real UK patient-doctor interactions, the researchers were also able to generate examples of each of the four key strategies to aid clinicians in adopting the communication techniques. 

The impact of poor communication around weight loss is wide ranging. It can cause distress for the patient, reinforce shame, blame and stigma, and can deter people living with obesity from seeking medical care in general. 

With obesity rates having more than doubled between 1990 and 2022 and more than 890 million adults now living with obesity worldwide, international guidance recommends clinicians offer weight loss support to their patients. However, many clinicians find it challenging to discuss weight loss constructively.  

Much existing advice and guidance for clinicians is general and unspecific, meaning that clinicians are unsure exactly what to say in practice. There are a lot of myths about how to communicate which aren’t really based on scientific evidence,’ explains Dr Charlotte Albury, lead author of the study and Associate Professor in the Nuffield Department of Primary Care Health Sciences.  

In this new study we highlight specific ways to communicate that are likely to be positively received by patients and useful for effective conversations,’ continued Dr Albury. ‘By bringing together evidence on specifically what to say, we hope conversations and experiences of care for patients and clinicians improve. 

The research was reviewed by a panel of people living with obesity and one member noted: If healthcare providers take note of this guidance, then it will make a huge difference to people's lives. 

 

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