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State of the Art Reviews: Patient and Physician Communication About Weight Management: Can We Close the Gap?

Department of Internal Medicine, Health Research Center, Park Nicollet Institute, Center, Minneapolis, Minnesota, beranm{at}parknicollet.com

Jinnet B. Fowles, PhD

Park Nicollet Institute, Health Research Center, Minneapolis, Minnesota

Elizabeth A. Kind, MS, RN

Park Nicollet Institute, Health Research Center, Minneapolis, Minnesota

Cheryl E. Craft, RN

Purpose. To understand and gain insight into improving communication about weight management between patients and physicians and answer the question, "How should physicians communicate with obese patients about weight management?" Design. Three patient focus groups of 5 participants each and 2 physician focus groups of 6 participants each, segregated by gender, during July and August 2004. Participants. Patients with a body mass index of 30, English speaking, aged 25 to 75 years. Physicians trained in internal medicine or family medicine from a large multispecialty group. Methods. Focus group discussions were transcribed verbatim, a coding scheme developed, and 4 independent reviewers coded each transcript. Consensus among reviewers was obtained. Results. Patients perceive that physicians do not initiate weight discussions, whereas physicians feel that they initiate these conversations regularly. Patients expressed desire for individualized information and advice about weight loss, yet physicians used 1 or 2 messages with all their patients and felt the individualized plans that some patients want are outside the role of the physician. Conclusion. Our results indicate that a communication gap does exist between patients and physicians about weight management. Individualized weight management advice by physicians for patients may reduce this gap.

Key Words: patient—physician communication • weight management • obesity • patient preferences • focus groups

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