Weight-loss talks: what works (and what doesn't)

Area of Science:

• Primary Care Medicine
• Obesity Research
• Behavioral Science

Background:

• Effectiveness of physician weight-related advice in primary care is unclear.
• Physician advice impact on patient weight loss requires investigation.

Purpose of the Study:

• Analyze physician weight-related advice given during primary care encounters.
• Measure changes in patient dietary intake, physical activity, and weight following advice.

Main Methods:

• Audio-recorded primary care encounters (40 physicians, 461 overweight/obese patients).
• Coded weight-related advice: nonspecific, specific nutritional, specific exercise, or specific weight.
• Mixed models assessed changes in diet, exercise, and weight 3 months post-encounter.

Main Results:

• Combined specific weight, nutrition, and physical activity advice (34%) led to reduced dietary fat intake (P=.02).
• Physical activity advice alone significantly increased patient weight (+1.41 kg, P=.02) compared to no advice.

Conclusions:

• Most physicians offer combined lifestyle recommendations for weight management.
• Combined advice may improve dietary fat reduction.
• Physical activity advice in isolation may be counterproductive for weight management.