Obesity is a chronic and relapsing condition, but physicians often lack guidance on which information is helpful for patients who would like to lose weight. As a result, the information patients receive can be hard to use and implement. Bad experiences are regularly reported by patients, who often see these conversations about weight as difficult.
The researchers analysed 159 audio recordings of consultations between general practitioners and patients living with obesity collected as from the United Kingdom between 2013 and 2014. The investigation found that weight-loss advice from doctors to patients with obesity rarely included effective methods and mostly consisted of telling patients merely to eat less and be more physically active. The advice was mostly generic and rarely tailored to patients’ existing knowledge and behaviours, such as what strategies they had tried to lose weight before.
The advice was mostly (97% of the time in analysed consultations) abstract or general. Superficial guidance, such as one doctor telling a patient to just “change their lifestyle a bit” was common. Doctors gave patients information on how to carry out their advice in only 20% of the consultations. They mostly offered weight loss guidance without any detail about how to follow it. Doctors frequently (76% of the time in the consultations) told patients to get help somewhere else for support in weight loss, often suggesting that they return for another consultation at their surgery.
Dr Madeleine Tremblett, co-lead author and Researcher in the Nuffield Department of Primary Care Health Sciences, University of Oxford, says:
'This research demonstrates that doctors need clear guidelines on how to talk opportunistically to patients living with obesity about weight loss, to avoid amplifying stigmatizing stereotypes and give effective help to patients who want to lose weight'.
The analysis indicated that when doctors did offer specific information it was often scientifically unsupported and unlikely to result in actual weight loss. The notion that small changes in behaviour (“take the stairs more often”) can have a large weight loss impact is a common myth and is even prevalent in scientific literature, but it isn’t supported by research. Another common myth was that patients just needed the “right mindset” to lose weight.
Annabel Poon, co-lead author, Medical Student at University of Cambridge and intern with the Nuffield Department of Primary Care Health Sciences, University of Oxford said:
'Weight loss advice currently given by GPs often perpetuates ‘myths’ regarding obesity, and fails to support patients to make beneficial lifestyle changes. This study highlights the need for better training for doctors to deliver evidence-based advice that is tailored to the individual patient in order to provide effective improvement to weight, health and wellbeing'.
The paper, 'What advice do general practitioners give to people living with obesity to lose weight? A qualitative content analysis of recorded interactions' is published in Family Practice.