Moral discourse in general practitioners' accounts of obesity communication

Obesity is not addressed with a large proportion of patients presenting in general practice. An increasing body of evidence suggests that health professionals view body weight as a sensitive topic to include in routine consultations and face barriers in initiating weight loss discussions. This study examined the discursive power relations that shape how general practitioners (GPs) understand and talk about obesity using a novel methodology to elicit responses from GPs about raising the topic of weight. Twenty GPs from the South West of England reflected upon novel trigger films simulating doctor-patient interactions, in which a doctor either acknowledged or ignored their patient's body weight. Underpinned by a discourse analytic approach, our findings suggest that GPs both reproduce and resist moral discourse surrounding body weight. They construct obesity as an individual behavioural problem whilst simultaneously drawing on socio-cultural discourse which positions body weight as central to social identity, situating obesity within a context of stigma and positioning patients as powerless to lose weight. Our findings highlight a need for increased reflexivity about competing discursive frameworks at play during medical consultations about obesity, which we suggest, contribute to increased tension and powerlessness for GPs. Trigger films are an innovative method to elicit information and discuss competing discourses.