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New recommendations for addressing obesity without judgment can help clinicians conduct productive, non-stigmatizing weight loss conversations with patients.
Although international guidelines encourage practitioners to initiate conversations about weight loss with patients with obesity, little guidance on how to conduct these conversations exists.
To address this lack of detail regarding consultation strategies, Charlotte Albury, PhD, and colleagues reviewed evidence-based research on productive weight loss management conversations and published their recommendations in JAMA.
Dr. Albury spoke with Physician’s Weekly (PW) regarding the findings of this study.
PW: What inspired you to research conversation tools for clinicians addressing weight with their patients?
Dr. Albury: Guidance recommends that clinicians talk to patients living with obesity about weight management, but both clinicians and patients report that they can find these conversations to be challenging. Guidance to support clinicians in having these conversations is very general, saying things like “be collaborative,” but it offers little detail for clinicians on how to achieve this in practice.
It was important to consolidate evidence generated from detailed empirical analysis of real consultations to highlight specific communication approaches clinicians can use in practice that can support positive and well-received conversations.
What are some key recommendations from your study?
We highlight a series of specific strategies that clinicians can use when talking to their patients living with obesity about weight management. This includes a gentle entry to discussing weight management, rather than doing so abruptly; avoiding “eat less, move more” messaging, which is unlikely to be effective; offering treatment rather than just advice; personalizing discussions through question-answer sequences; and framing conversations positively, emphasizing the benefits of weight loss rather than the harm [of] obesity. This would include using a conversational technique called optimistic projections to highlight possible future benefits.
How can your findings be incorporated into practice?
Our review is designed to consolidate available evidence for clinicians to use in practice. The good news is that the recommendations we provide can be incorporated into any weight management conversations between clinicians and patients living with obesity. They provide support for what specifically to say at each stage of a conversation and also remind clinicians of communication techniques to avoid.
Why is efficient communication about weight important?
Obesity is a growing global health concern, but there are many myths about how to raise this issue and discuss weight loss with patients. The strategies we identify are important because they provide evidence-based approaches clinicians can use to support their patients confidently.
How can we continue to address the gap between communication guidance for clinicians and evidence-based best practices?
Good communication is fundamental to healthcare encounters and supports better patient outcomes. However, much of the communication guidance for clinicians does not provide specific strategies and is not based on empirical evidence of how best to communicate. This means clinicians rarely have access to or training in specific techniques that are most likely to realize optimal benefits.
Future research should focus on identifying further empirical evidence of effective communication practices across various settings. This evidence should then be used to inform guidance and training for clinicians, supporting more effective communication and better outcomes.
