Weight Loss Counseling at the Dr’s Office

dr_weight_counselingOverweight and obese patients trust diet advice from heavy doctors most, according to a new study. The survey of more than 600 overweight and obese patients found that overall patients reported a fairly high trust level, regardless of their doctors’ weight. On a scale ranging from 0-10 (with 10 being the highest), normal-weight doctors averaged a trust score of 8.6, overweight 8.3 and obese 8.2. When it came to trusting diet advice, however, the doctors’ weight status mattered more. While 77% of those seeing a normal-weight doctor trusted the diet advice, 87% of those seeing an overweight doctor trusted the advice, and 82% of those seeing an obese doctor. Although this may seem counter-intuitive, the researchers speculated that “it has to do with this shared identity.” Patients may think an overweight or obese doctor understands what they are going through, whereas a normal weight doctor may be perceived as more judgemental. But because overweight doctors may not be comfortable talking about weight loss, patients may have to start the conversation and ask for help – perhaps even for a referral to a nutritionist, said the researchers.

Many hope that with the growing obesity rates, doctors would be highly proactive in discussing the topic of losing weight – however patients concerned with their weight may indeed need to broach the subject with their doctor.  A recent study found that the amount of weight counseling offered by primary care physicians has decreased. Patients seen in 2007-2008 were almost 50% less likely to receive weight counseling compared to 1995-1996. The Penn State College of Medicine researchers reported that weight counseling occurred in only about 6% of total visits in 2007-2008.

In the United States today, it is estimated that nearly 150 million adults are overweight or obese. At the time of the first study in 1995, the percentage of adults who were overweight or obese was 52%. By 2008 that figure had grown to 63%. Researcher Jennifer Kraschnewski, Assistant Professor of Medicine, explained that “It is striking that the odds of weight loss counseling declined by 41 percent, with only 30 percent of obese patients receiving counseling in 2007-2008, given the substantial increases in the rates of overweight and obesity during that time.”  Perhaps even more troubling is the finding that patients with diabetes or high blood pressure were significantly less likely to receive counseling, and often these are the patients who could benefit the most from losing weight. The researchers listed some of the potential barriers for physicians to offer weight counseling, including time restraints during appointments, thinking that they lack adequate training for lifestyle counseling, pessimism that patients can change, and that counseling services are not always reimbursed.

We spoke to Los Angeles bariatric surgeon, Dr. Scott Cunneen, about the research.  He said, “What this study demonstrates, but is not noted in the conclusions by the authors, is that a problem with your weight is something that is very visible to all around you. This is unlike most other medical problems patients encounter. So, it seems very natural that patients would respond differently to their physicians and have greater trust in those who they know are struggling with the same issues that they are. The study also demonstrates that they tend to trust to a greater degree the physicians who are obviously more successful at controlling their own personal issues with weight, since there is more trust in those physicians who are overweight than those who are obese. What would be interesting to know, but was not stated in the study, is whether there was a difference in perception of their normal weight physicians if they knew that they formally had an weight problem and that they had successfully navigated their way out of it.”

Additionally, we asked Dr. Mona Misra to comment on the study. She said that it demonstrates that a fantastic opportunity to connect to patients exists when physicians actively become role models and relate personal experiences with weight loss strategies.  “As this study demonstrates, patients tend to trust options they know physicians choose for themselves,” she concluded.

Related Reading: Are Doctors Addressing Weight with Patients?

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