KEY MESSAGE(S):· General practitioners want to play a relatively passive role in the management of obesity · Motivating patients is a key goal of primary care consultations on obesity · Perceived lack of motivation in patients is an important barrier to successful obesity management by general practitioners ABSTRACT Background: Increasing prevalence of obesity worldwide requires providing support for many patients. GPs in particular, as longterm supervisors of patients, are asked to deliver care to those aff ected. Objectives: This qualitative study aimed at identifying GPs ' perspectives on counselling overweight and obese patients. Methods: To that end, semi-structured interviews were conducted in Berlin with GPs regarding their objectives and barriers in overweight care. Fifteen GPs participated; interviews were audio taped, transcribed and analysed using qualitative content analysis. Results : Analysis showed a diff erentiated pattern of medical and psychosocial objectives in obesity treatment. Overall, it was seen that GPs wanted to play a relatively passive role in treatment of obesity. In particular, motivating patients was a key goal of primary care consultations; at the same time patients ' lack of motivation was a main barrier to successful treatment. Conclusion:Care for obese patients is perceived as ineff ective and frustrating. Recommended solutions include further education to improve GPs ' communication techniques, e.g. to trigger patients ' motivation.

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Options should be developed for closer cooperation between GPs and support facilities inside and outside practices.

Our results indicate that GPs rarely use the check-up program to conduct lifestyle consultations with obese patients. Barriers to lifestyle counseling and possible solutions are discussed with a view to promoting individualized and target management of overweight patients.

Background: Stress-related, behavioral or chronic diseases require a holistic therapeutic approach. Mind-body medicine (MBM) uses the interaction between mind, body, behavior, and the environment to affect physical and psychological health and function. This integrative strategy can be applied in clinical settings, e.g., in an outpatient clinic, to improve well-being as well as clinical outcomes. We hypothesized an improvement of flourishing, mindfulness, sense of coherence, and quality of life through a comprehensive MBM program. In addition, we hypothesized correlations between the measures themselves as well as between the measures influenced by the intervention. Methods: We conducted a longitudinal cohort study in an outpatient clinic setting (n = 48 patients, with various diagnoses). A questionnaire battery, consisting of SF-12, Flourishing Scale (FS, FS-D), Freiburg Mindfulness Inventory (FMI), and Sense of Coherence Scale (SOC9), was used and applied in a pre-to-post format over a period of 18 weeks. The intervention was a 12-week MBM group program, with 1 session of 7 h per week. Results: The pre-post comparison of the measures showed significant improvements in psychological health, flourishing, mindfulness, and coherence. We were able to verify correlations between the measures themselves, apart from physical health. Coherence correlated with psychological health, influenced by the intervention. Further analyses showed associations between coherence, mindfulness, and flourishing. Conclusions: The MBM program improved measures of psychological health and decreased the level of suffering from chronic disease. MBM led to an improvement of disease coping and appraisal of individual ailments, thereby enhancing quality of life. Personal flourishing, coherence, and mindfulness seem to interact with each other.