Losing weight is never easy, and having your doctor bring your weight up during an office visit can be either humiliating or inspiring, depending on how he or she addresses the issue — if it is addressed at all.
When the topic does come up, the interaction is often simply the doctor’s advice to lose weight, rather than an offer of treatment to support weight loss.
To determine the effect of provider language on patients’ weight loss, a study by researchers in the United Kingdom looked more closely at what doctors say to their overweight patients and how they say it.
When doctors presented weight-loss as an opportunity and helped patients find a program, it led to more patients losing more weight.
The team, led by researchers from the University of Oxford, analyzed recorded conversations between 246 patients with obesity and 87 clinicians about a 12-week weight-loss program. The behavioral management program was available at no cost to patients.
They classified the language used by providers during these interactions regarding the weight-loss program as taking one of three approaches: 1) a ‘good news’ approach, in which their general practitioners recommended and offered to facilitate a referral to an effective behavioral weight management program for 12 weeks free of charge. It rarely mentioned obesity, body mass index or weight as a problem; 2) A neutral approach that was matter-of-fact and did not have any positive or negative features; or 3) a ‘bad news’ approach that highlighted the dangers of obesity and the challenges of weight control.
Presenting losing weight in a positive light led to more patients starting a weight-loss program and losing more weight compared to patients whose providers took a neutral or more negative approach to the conversation.
Among the three approaches, the neutral approach was the one doctors used the most, while the good news approach was the least common, even though patients who were counseled using this positive approach lost the most weight at the end of 12 months — about 10.6 pounds.
Patients whose doctors counseled their patients using bad news approach focused on the health risks of obesity lost six pounds. Patients of doctors using a neutral approach lost a little less than three pounds.
Compared to the other two groups, more patients (87 percent) in the encouraging, good news group enrolled in the weight-loss program, and this could be the reason they lost the most weight. A neutral or negative approach to weight-loss counseling really did not help.
“[There’s] a lot of work to do to educate clinicians about better ways of addressing obesity and weight management,” Wee, a part-time associate professor of medicine at Harvard Medical School, said. She hopes the results will encourage doctors to change how they talk to their patients about any sensitive topic, especially weight management.