A new research study published in Family Practice , published by Oxford University Press, finds that when doctors tell patients living with obesity to lose weight, the guidance they give is generally vague, superficial, and often It is not supported by scientific evidence.
What advice do general practitioners give to people living with obesity to lose weight? A qualitative content analysis of the recorded interactions Summary Background Guidelines recommend that general practitioners (GPs) take every opportunity to talk to people living with obesity about their weight, and evidence shows that even very brief advice is associated with weight loss. However, little is known about what GPs say when giving brief behavioral advice and whether it reflects evidence-based recommendations for people living with obesity. To understand what behavioral advice GPs give, we categorized the content and delivery of GP advice during brief interventions. Methods Qualitative content analysis was applied to 159 audio recordings of consultations from the Brief Interventions for Weight Loss (BWeL) trial, where GPs gave brief weight loss advice to patients with a body mass index ≥30 kg. /m2 (or ≥25 kg/m2). if Asian) in 137 UK surgeries. Similar content was grouped into descriptive groups. Results The results comprised 4 groups, which shed light on different aspects of the advice given: (i) Content of the advice on diet and physical activity, which was shown to be very varied; (ii) Content of "implementation advice" provided to support the changes, e.g. using smaller plates; (iii) Content of signposting support, whether towards further medical support or other resources, e.g. information brochures; (iv) Advice delivery style, showing that GPs rarely provide personalized advice or the reasons for their advice. Conclusions and consequences GPs’ weight loss advice to patients with obesity rarely included effective methods , mostly communicating a general "eat less and move more" approach . The advice was mostly generic and rarely tailored to patients’ existing knowledge and behaviour. The effectiveness of brief weight loss advice could be improved if GPs received clearer guidance on evidence-based recommendations. |
Comments
Obesity is a chronic, relapsing condition, but doctors often lack guidance on what information is useful for patients who want to lose weight. As a result, the information patients receive can be difficult to use and implement. Bad experiences are regularly reported by patients, who often view these conversations about weight as difficult.
Researchers analyzed 159 audio recordings of consultations between general practitioners and patients living with obesity collected in the United Kingdom between 2013 and 2014. The research found that weight loss advice from doctors to patients with obesity rarely included effective methods and They mainly consisted of telling patients to simply eat less and be more physically active. The advice was mostly generic and rarely tailored to patients’ existing knowledge and behaviors, such as strategies they had tried to lose weight before.
The advice was mostly (97% of the time in the consultations analyzed) abstract or general.
Superficial guidance, such as a doctor telling a patient to just "change your lifestyle a little," 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 . Doctors 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 offered specific information, it was often unsupported by science and unlikely to result in actual weight loss. The notion that small changes in behavior ("taking the stairs more often") can have a big impact on weight loss is a common myth and is even prevalent in the scientific literature, but it is not supported by research. Another common myth was that patients only needed the "right mindset" to lose weight.
“This research demonstrates that doctors need clear guidelines on how to talk opportunistically with patients living with obesity about weight loss,” said one of the paper’s lead authors, Madeleine Tremblett. “This can help them avoid the amplification of stigmatizing stereotypes and provide effective help to patients who want to lose weight.”
Conclusion
Primary care physicians are not sure what advice is effective when discussing weight with patients living with obesity, and they believe that patients do not follow the advice they are given. Our analysis identifies that doctors mostly do not provide effective advice and therefore, even if patients followed the advice, they are unlikely to lose weight .
When physicians lacked support services to offer patients, they commonly advocated a general "eat less, do more" approach. This message is not liked by patients and is unlikely to be effective. Future training and guidelines can address misconceptions that this approach is effective for the population of people living with obesity and instead emphasize the importance of offering support through referrals to weight management services, if appropriate. possible.
Simple Summary
Current guidelines strongly recommend general practitioners (GPs) talk to people living with obesity about weight loss. Evidence has shown that conversations with a doctor about weight management can be very effective, as even very brief advice has been associated with weight loss. To understand what GPs are actually saying when offering weight loss advice to patients with obesity, we analyzed 159 audio recordings of conversations between GPs and patients. We found that doctors mainly gave generic messages about diet and exercise, for example, "reduce your carbs" and "move more . " Furthermore, weight loss advice was often not tailored to patients’ existing knowledge and behaviors. Obesity is a chronic, recurring condition, but patients did not receive specific or evidence-based advice to help them manage this. The findings suggest that doctors’ brief weight loss advice could be more effective if they were given clearer guidance about which weight loss methods have been shown to actually work.
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