Physicians’ Weight Loss Counseling in Two Public Hospital Primary Care Clinics

Abstract

Physicians' weight loss counseling had a significant effect on patients' understanding of and motivation for weight loss. However, physicians provided insufficient guidance on weight management strategies, possibly because of inadequate counseling skills and confidence.

Explanations for Unsuccessful Weight Loss Among Bariatric Surgery Candidates

“…This reinforces current recommendations that clinicians offer a comprehensive approach to obesity treatment, rather than focus on any single issue with which they are most comfortable [1,22]. Given that primary care providers typically lack the time and skills to provide comprehensive obesity management [23][24][25][26], a division of labor is needed in which specialized personnel (e.g., dietitians, fitness professionals, health counselors) provide behavioral weight loss services as part of a comprehensive program [27][28][29]. Implementing this model of care would require shifting focus from training primary care providers to become weight loss counselors to incorporating specialized weight loss counselors into the primary care team [30][31][32].…”

Prevalence and Determinants of Engagement with Obesity Care in the United States

“…Our finding that few individuals with obesity make it to the end of the cascade suggests that there is significant unmet need for obesity care at the population level. Engaging with this last step is essential to gaining access to managed, effective care and can result in a myriad of treatment outcomes, including behavioral modification, pharmacotherapy, bariatric surgery, and/or referral to another care provider 17, 18, 19, 20, 21. Our findings thus highlight the need for physicians to engage in conversation about obesity treatment at routine clinical visits, even when patients are not seeking obesity care.…”

From the Patient’s Perspective: The Impact of Training on Resident Physician’s Obesity Counseling

“…[3][4][5] Modest weight loss with diet and exercise can improve health outcomes. 6 Physician counseling is associated with improved diet and physical activity, 7 readiness for lifestyle change, 8 and short-term weight loss. 9,10 Thus, several organizations recommend that physicians should counsel obese patients to lose weight [11][12][13] .…”

“…7,[14][15][16] When counseling does occur, most physicians do not discuss specific behavior change recommendations such as diet and exercise, 8 indicating that quality of counseling may be poor. Lack of training and competency in obesity management are among the reasons that physicians do not adequately counsel patients.…”

“…Lack of training and competency in obesity management are among the reasons that physicians do not adequately counsel patients. 8,[17][18][19] The 5As counseling framework is an evidence-based way to teach physicians to counsel obese patients 19,20 and measure the quality of obesity counseling. 21 This framework guides providers to assess risk, current behavior, and readiness to change, advise change of specific behaviors, agree and collaboratively set goals, assist in addressing barriers and securing support, and arrange for follow-up.…”