Surprise! Vague Weight Loss Advice Fails Us

Decades have passed with medical experts talking about an “obesity epidemic.” Meanwhile the prevalence of this condition rose without a pause. A new study in Family Practice offers some insight into how this plays out in primary care. Madeleine Tremblett, Annabel Poon, Paul Aveyard, and Charlotte Albury analyzed 159 recordings of advice from GPs to patients with obesity in the UK. Rarely did this advice include any information about effective approaches for weight management. Instead, the dominant approach was vague weight loss advice. It amounted to telling patients they should “eat less and do more.” Tremblett explains the significance of her findings:

“This research demonstrates that doctors need clear guidelines on how to talk opportunistically to patients living with obesity about weight loss. This can help them to avoid amplifying stigmatizing stereotypes and give effective help to patients who want to lose weight.”

Qualitative Content Analysis

This research applied qualitative content analysis to recordings interactions with patients that were part of another study – the Brief Interventions for Weight Loss trial. The BWeL trial was a study of the effectiveness of referring patients to a behavioral support program for weight loss. The control group was standard care – brief advice to lose weight for improved health. Tremblett et al used recordings of advice from the control group for their new analysis. The found that the “advice was mostly generic, and rarely tailored to patients’ existing knowledge and behaviours.”

“Instruct the Patient to Lose Weight”

This study is helpful, though the results are not surprising. The GPs in this study were from the UK, but Ethan Lazarus has described a similar situation in U.S. family medicine practices. Instruct the patient to lose weight was the only thing he needed to know on this subject for his board exams.

Such instructions seldom produce a clinical benefit, because trying to lose weight is something that most people living with obesity have already done. What we need is actual, clinically effective help with this complex, chronic disease.

DIY is seldom an effective strategy for overcoming obesity.

Click here for the study in Family Practice, here, here, and here for further perspective.

Surprise, photograph by Ralf Steinberger, licensed under CC BY 2.0

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December 14, 2022