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State of the Art Reviews: Patient and Physician Communication About Weight Management: Can We Close the Gap?
Mary Sue Beran, MD, MPH
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
References
- Mokdad AH, Bowman BA, Ford ES, Vinicor F., Marks JS, Koplan JP The continuing epidemics of obesity and diabetes in the United States. JAMA. 2001;286:1195-1200.[Abstract/Free Full Text]
- US Preventive Services Task Force. Screening for obesity in adults: recommendations and rationale. Ann Intern Med. 2003;139:930-932.[Abstract/Free Full Text]
- Smith BJ, Merom D., Harris P., Bauman AE Do primary care interventions to promote physical activity work? A sys tematic review of the literature. National Institute of Clinical Studies, Melbourne, Australia. Published December 2002. http://www.cpah.health.usyd.edu.au/pdfs/2003_primary_care_interventions.pdf. Accessed April 20, 2006.
- Galuska DA, Will JC, Serdula MK, Ford ES Are health care professionals advising obese patients to lose weight? JAMA. 1999;282:1576-1578.[Abstract/Free Full Text]
- Befort CA, Greiner KA, Hall S., et al. Weight-related perceptions among patients and physicians: how well do physicians judge patients' motivation to lose weight? J Gen Intern Med. 2006;21:1086-1090.[CrossRef][Medline]
[Order article via Infotrieve]
- Bocquier A., Verger P., Basdevant A., et al. Overweight and obesity: knowledge, attitudes, and practices of general practitioners in France. Obes Res. 2005;13:787-795.[Medline]
[Order article via Infotrieve]
- Kreuter MW, Chheda SG, Bull FC How does physician advice influence patient behavior? Evidence for a priming effect. Arch Fam Med. 2000;9:426-433.[Abstract/Free Full Text]
- Bull FC, Jamrozik K. Advice on exercise from a family physician can help sedentary patients to become active. Am J Prev Med. 1998;15:85-94.[CrossRef][Medline]
[Order article via Infotrieve]
- Lewis BS, Lynch WD The effect of physician advice on exercise behavior. Prev Med. 1993;22:110-121.[CrossRef][Medline]
[Order article via Infotrieve]
- Wee CC, Davis RB, Phillips RS Stage of readiness to control weight and adopt weight control behaviors in primary care. J Gen Intern Med. 2005;20:410-415.[CrossRef][Medline]
[Order article via Infotrieve]
- Potter MB, Vu JD, Croughan-Minihane M. Weight management: what patients want from their primary care physicians. J Fam Pract. 2001;50:513-518.[Medline]
[Order article via Infotrieve]
- Scott JG, Cohen D., DiCicco-Bloom B., et al. Speaking of weight: how patients and primary care clinicians initiate weight loss counseling. Prev Med. 2004;38:819-827.[CrossRef][Medline]
[Order article via Infotrieve]
- Abid A., Galuska D., Khan LK, Gillespie C., Ford ES, Serdula MK Are healthcare professionals advising obese patients to lose weight? A trend analysis. MedGenMed. 2005;7:10.[Medline]
[Order article via Infotrieve]
- Logue EE, Smucker WD Obesity management in primary care: changing the status quo. J Fam Pract. 2001;50:520.[Medline]
[Order article via Infotrieve]
- Hebl MR, Xu J., Mason MF Weighing the care: patients' perceptions of physician care as a function of gender and weight. Int J Obes Relat Metab Disord. 2003;27:269-275.[CrossRef][Medline]
[Order article via Infotrieve]
- Wee CC, McCarthy EP, Davis RB, Phillips RS Physician counseling about exercise. JAMA. 1999;282:1583-1588.[Abstract/Free Full Text]
- National Heart, Lung, and Blood Institute, National Institutes of Health. The practical guide: identification, evaluation, and treatment of overweight and obesity in adults. Published October 2000. http://www.nhlbi.nih.gov/guidelines/obesity/prctgd_c.pdf. Accessed April 20, 2006.
- Swinburn BA, Walter LG, Arroll B., Tilyard MW, Russell DG The green prescription study: a randomized controlled trial of written exercise advice provided by general practitioners. Am J Public Health. 1998;88:288-291.[Abstract/Free Full Text]
- Ainsworth BE, Youmans CP Tools for physical activity counseling in medical practice. Obes Res. 2002;10(suppl 1):69S-75S.[Medline]
[Order article via Infotrieve]
- Crabtree BF, Miller WL Doing Qualitative Research. 2nd ed. Thousand Oaks, CA: Sage; 1999.
- Sciamanna CN, Tate DF, Lang W., Wing RR Who reports receiving advice to lose weight? Results from a multistate survey. Arch Intern Med. 2000;160:2334-2339.[Abstract/Free Full Text]
- Huang J., Yu H., Marin E., Brock S., Carden D., Davis T. Physicians' weight loss counseling in two public hospital primary care clinics. Acad Med. 2004;79:156-161.[CrossRef][Medline]
[Order article via Infotrieve]
- Manson JE, Skerrett PJ, Greenland P., VanItallie TB The escalating pandemics of obesity and sedentary lifestyle. A call to action for clinicians. Arch Intern Med. 2004;164:249-258.[Abstract/Free Full Text]
- Simkin-Silverman LR, Gleason KA, King WC, et al. Predictors of weight control advice in primary care practices: patient health and psychosocial characteristics. Prev Med. 2005;40:71-82.[CrossRef][Medline]
[Order article via Infotrieve]
- Anderson C., Peterson CB, Fletcher L., Mitchell JE, Thuras P., Crow SJ Weight loss and gender: an examination of physician attitudes. Obes Res. 2001;9:257-263.[Medline]
[Order article via Infotrieve]
- Glanz K., Rimer BK, Lewis FM Health Behavior and Health Education: Theory, Research, and Practice. 3rd ed. San Francisco, CA: Jossey-Bass; 2002.
American Journal of Lifestyle Medicine, Vol. 2, No. 1,
75-83 (2008)
DOI: 10.1177/1559827607308805
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