Youth Preferences for Weight-Related Conversations

Little guidance is available to clinicians on how to talk about weight with their patients. The aim of this study is to explore youth preferences for weight-related conversations. Participants came from the National MyVoice Text Message Cohort. Between 7/2017 and 01/2018, 952 MyVoice participants provided open-ended responses via text message to three questions about weight-related conversations ("Has your doctor ever talked to you about weight?", "What did he or she say?", and "What should a doctor NOT say when talking about weight?"). The presence of themes was coded using standard qualitative methods. Of the 952 respondents, 568 (60%) reported that their doctor had talked with them about weight. Of these, 85% indicated that their doctor had notified them of their weight, BMI, or weight status and/or the need to change their body weight and 16% had doctors who provided advice about weight control. Eight themes emerged from the analysis of responses to the question "What should a doctor NOT say when talking about weight?". The two most common themes were: (1): Avoid stigmatizing terms/language (32%); and (2) Do not shame patient for their weight (25%). Findings suggest that weight-related conversations do not reflect the preferences of the youth they are designed to benefit. Youth recommended that clinicians focus on health and sustainable behavioral solutions, avoid stigmatizing language and comparing them to others, and be aware of the potential harm associated with making assumptions that conflate weight with health behaviors, morality, or appearance.