Should Doctors Tell You You’re Overweight?


A 30-second discussion about a patient’s weight can lead to improved health outcomes, including a trimmed waistline.

Also, despite perceptions in the medical community suggesting otherwise, most patients don’t mind a frank discussion about their weight, concludes a new study in The Lancet.

For the study, researchers tracked more than 2,200 obese patients and how they reacted to a brief discussion with their primary care provider about their weight. Just four patients overall – or less than one percent of the study group – found the conversations inappropriate or meaningless, according to the study. More than four out of five patients – about 81 percent – reacted positively and reported the conversations were beneficial.

“Doctors can be concerned about offending their patients by discussing their weight, but evidence from this trial shows that they should be much less worried. Our study found that a brief, 30-second conversation, followed by help booking the first appointment onto a community weight loss program, leads to weight loss and is welcomed by patients,” said Paul Aveyard, the study’s lead author and a professor at the University of Oxford.

And perhaps most importantly, the physician-led interventions had a positive impact on patient health, with an average loss of more than two pounds across the entire study group.

Referral to weight-loss programs extra helpful

“Guidelines recommend that physicians screen and offer brief advice to motivate weight loss through referral to behavioral weight loss programs. However, physicians rarely intervene and no trials have been done on the subject,” write the study authors.

To gauge the impact of a doctor’s intervention, the study authors divided the 2,200 patients into two groups – doctors had a brief discussion with both groups but specifically referred just one group to an official weight-loss program.

The targeted referral appears to have a greater impact on the patient’s behavior than the conversation alone; patients that received the referral information lost an average of 3.1 pounds over the course of the study period, while patients that had the conversation without the referral lost an average of 2.2 pounds.

For both groups, the doctors used a standard script to engage the obese patients. For example, a physician would say, “While you’re here, I just wanted to talk to you about your weight. You know the best way to lose weight is to go to [a specific weight-loss center or program].”

Physicians took an extra step with the patients whom they referred by following up to ensure the patient went through with the appointment as directed. Ultimately, the researchers conclude that “a brief opportunistic intervention by physicians to motivate weight loss in unselected patients who are obese was highly acceptable to patients. When combined with supportive systems, the intervention led to overall population weight loss.

Also, the authors note that primary care physicians can play a strategic role in achieving these goals. “On average, people consult their doctor five times a year meaning there is huge opportunity to deliver this low cost intervention on a large scale,” write the study authors.