A new research study finds that when doctors tell patients living with obesity to lose weight, the guidance they give is often vague, superficial, and often unsupported by scientific evidence. The study was published December 13 in the journal family practice, by Oxford University Press.
Obesity is a chronic and relapsing condition, but clinicians often lack guidance on what information is helpful to patients wanting to lose weight. As a result, the information that patients receive can be difficult to use and implement. Bad experiences are regularly reported by patients, who often view these weight conversations as difficult.
Researchers analyzed 159 audio recordings of consultations between general practitioners and patients living with obesity collected in the UK between 2013 and 2014. The research found that doctors’ weight loss advice to obese patients rarely included effective methods and they consisted mainly of telling patients to simply eat less and be more physically active. The advice was mostly generic and rarely adapted to the patients’ existing knowledge and behaviors, such as strategies they had tried before to lose weight.
The advice was mostly (97% of the times in the queries analyzed) abstract or general. Superficial guidance, such as a doctor telling a patient to just “change her lifestyle a little bit,” was common. Doctors gave patients information on how to carry out their advice in only 20% of consultations. They mostly offered weight loss guidance without any details on how to follow it. Physicians frequently (76% of the time in consultations) told patients to seek help elsewhere to help them lose weight, often suggesting that they return for another consultation at their surgery.
The analysis indicated that when doctors did offer specific information, it often had no scientific backing and was unlikely to result in actual weight loss. The notion that small changes in behavior (“walking up the stairs more often”) can have a big impact on weight loss is a common myth and even prevalent in the scientific literature, but not supported by research. Another common myth was that patients just needed the “right mindset” to lose weight.
“This research demonstrates that clinicians need clear guidance on how to opportunistically talk to patients living with obesity about weight loss,” said one of the paper’s lead authors, Madeleine Tremblett. “This can help them avoid amplifying stigmatizing stereotypes and provide effective help to patients who want to lose weight.”
Reference: “What advice do general practitioners give people living with obesity to lose weight? A qualitative content analysis of recorded interactions” by Madeleine Tremblett, Annabel YX Poon, Paul Aveyard, and Charlotte Albury, December 13, 2022, family practice.