Patients may be more likely to lose weight successfully if their GP uses positive language, say researchers who have urged clinicians to take a ‘good news’ approach.
Presenting weight loss as a positive opportunity was associated with a greater uptake of treatment and more success when patients did try to lose weight, the team at the University of Oxford found.
They analysed conversations between 246 patients with obesity and 87 clinicians who were referring patients to a 12-week behavioural weight management programme as part of a trial.
Researchers split the conversations into three categories – those that framed the referral as ‘good news’, those that were largely centred on bad news around the harms of obesity and discussions that were neutral.
Offering the opportunity in a positive way was associated increased sign up and attendance to the programme as well as weight change compared with the neutral conversations, they reported in the Annals of Internal Medicine.
Overall, only 50% of people offered weight loss programmes in a neutral way attended, but if offered as ‘good news’ 83% attended, and people in the ‘good news’ group lost half a stone more (or 3.6kg).
In the positive group, doctors had emphasised the benefits of weight loss in an upbeat manner and had framed referrals as positive opportunities, delivering the information fluently and cheerfully, the researchers said.
The finding that subtle aspects of communication, like word choice and tone of voice, influences patient outcomes, suggests that training providers on compassionate communication could aid weight loss efforts, they concluded.
Previous research has shown that doctors can be hesitant to bring up weight or obesity because they are worried about causing offense.
Patients have also reported that that negative feelings arising from the tones or word choices used which can inadvertently strain the rapport with the GP, the team said.
Dr Charlotte Albury, lead author and researcher within the Nuffield Department of Primary Care Health Sciences, said: ‘What we found was that when doctors framed the conversation as “good news” – emphasising the benefits and opportunities of weight loss in a positive manner – patients were more likely to enrol in a weight loss programme, attend more sessions, and, importantly, lose more weight compared to a neutral or negative framing.’
She added that for those who received the referral as bad news or in a neutral way, only half of the people accepted the referral, and there was no significant difference in weight loss between them.
A key finding was that the impact of that conversation appeared to have a long-term impact on weight loss of up to a year later.
‘Until now, the long-term impact of communication variations in this context remained unexplored. Our findings give us a new understanding that could significantly alter how medical professionals approach conversations with patients.’
Type 2 diabetes treatment tirzepatide has now been licensed in the UK for weight loss, the medicines regulator announced last week.
This is a complete non starter, for a variety of reasons; all referrals to tier 3 weight management services have been frozen; the population we look after usually want a quick fix, rather than change their lifestyle, only 3 people out of all I have spoken to about this in the last 12 months have been really interested to take my advice and make changes to their lifestyle. And “doctors needing to be cheerful” when talking about this? What is there to be cheerful about, the ongoing work dumping to GP from everybody else, patients asking us to sort out their social issues because we are the only very accessible public service, the ongoing lack of funding and further cuts proposed to the various additional services we offer? Dr Albury should spend some time in general practice to see what life at the front line is like before making such ridiculous suggestions.