Doctors told to stop fat-shaming: Obese patients are more likely to lose weight if medics use ‘optimistic tone’, study says

A stern word from the doctor was once the go-to prescription for anyone looking to lose a few pounds.

But it turns out physicians should avoid calling patients fat if they want to help them lose weight, a study suggests.

Patients are more likely to lose weight if their doctor gives advice using an optimistic tone – with little mention of obesity, body mass index, or weight as a problem.

Oxford University researchers found people lost the most weight when treatments for obesity were presented as good news and an ‘opportunity’ rather than emphasizing the negative consequences of obesity.

Patients are more likely to lose weight if their doctor gives advice using an optimistic tone – with little mention of obesity, body mass index, or weight as a problem

They were less likely to participate in the programs and lose weight if doctors emphasized the negative consequences of obesity or used neutral language.

Patient encounters were analyzed at 38 doctor surgeries in England, with recordings taken of 87 general practitioners (GPs) speaking to patients about a free 12-week weight-loss program.

Researchers assessed whether the language used in the appointment had an impact on patient behaviors, including participation in the program and weight-loss outcomes.

These exchanges were then classified into three categories – as ‘good news’, ‘bad news’ and ‘neutral’.

Those who used the good news approach communicated positively and with optimism, focused on the benefits of weight loss, and presented the weight-loss program as an opportunity.

These doctors made little mention of obesity, body mass index, or weight as a problem, according to the findings published in the Annals of Internal Medicine.

Others emphasized the ‘problem’ of obesity – focusing on challenges of weight control, with a delivery that conveyed regret and pessimism.

The neutral news delivery – the most commonly observed – lacked either positive or negative features.

Those in the good news counselling approach lost the most weight, losing an average of 10.6lb (4.8kg) in 12 months, compared with 6lb (2.7kg) in the bad news group and 2.6lb (1.2kg) among neutrals.

Researcher suggested this was likely driven by a higher rate of people signing up to the 12-week weight-loss program at 87 per cent, compared to less than half in the other groups.

They said the findings ‘could significantly alter how medical professionals approach conversations with patients.’

Dr Charlotte Albury, lead author and researcher within the Nuffield Department of Primary Care Health Sciences at the University of Oxford, said it showed the importance of positivity.

She said: ‘What we found was that when doctors framed the conversation as ‘good news’ – emphasizing the benefits and opportunities of weight loss in a positive manner – patients were more likely to enroll in a weight-loss program, attend more sessions, and, importantly, lose more weight compared to a neutral or negative framing.

‘We know words matter, and this research shows they really do – in the short and long-term.

‘Overall, our research shows that subtle changes in communication can significantly influence patient outcomes one year later.

‘The elements that constituted ‘good news’ were subtle but had a clear and positive impact.’

WHAT SHOULD A BALANCED DIET LOOK LIKE?

Meals should be based on potatoes, bread, rice, pasta or other starchy carbohydrates, ideally wholegrain, according to the NHS

• Eat at least 5 portions of a variety of fruit and vegetables every day. All fresh, frozen, dried and canned fruit and vegetables count

• Base meals on potatoes, bread, rice, pasta or other starchy carbohydrates, ideally wholegrain

• 30 grams of fibre a day: This is the same as eating all of the following: 5 portions of fruit and vegetables, 2 whole-wheat cereal biscuits, 2 thick slices of wholemeal bread and large baked potato with the skin on

• Have some dairy or dairy alternatives (such as soya drinks) choosing lower fat and lower sugar options

• Eat some beans, pulses, fish, eggs, meat and other proteins (including 2 portions of fish every week, one of which should be oily)

• Choose unsaturated oils and spreads and consuming in small amounts

• Drink 6-8 cups/glasses of water a day

• Adults should have less than 6g of salt and 20g of saturated fat for women or 30g for men a day

Source: NHS Eatwell Guide