Primary care providers' communication with patients during weight counseling: a focus group study

Primary care providers (PCPs) are encouraged to counsel their obese patients about weight loss. We used focus groups to explore how PCPs communicate with patients about weight management.

During the summer of 2010, we conducted five focus groups of community-based PCPs who had patients enrolled in a practice-based, randomized controlled weight loss trial in Maryland. Focus groups were audio-recorded and transcribed verbatim. Two investigators independently coded transcripts for thematic content using editing style analysis.

Twenty-six PCPs from six different practices participated. Mean years in practice were 16.4 (SD 11.7) and 77% practiced internal medicine. We identified three communication-based themes about weight loss counseling: (1) motivating patients to lose weight, (2) partnering with the patient to achieve weight loss, and (3) handling challenges that arise during weight counseling.

PCPs use a variety of strategies to communicate with their patients about weight loss. Some PCPs already use patient-centered approaches to communicate with their patients about weight loss, suggesting that future weight counseling interventions should be tailored to build upon this strength.

PCPs' weight loss counseling may be improved by using techniques with demonstrated behavior change effectiveness such as the 5A's or motivational interviewing.