Doctors told to stop fat-shaming: Obese patients are more likely to lose weight if doctors use ‘optimistic tone’, says study

A stern word from the doctor was once the prescription for anyone who wanted to lose a few pounds.

But it turns out doctors should avoid calling patients fat if they want to help them lose weight, a study suggests.

Patients are more likely to lose weight if their doctor gives advice in an optimistic tone – without mentioning obesity, body mass index or weight as a problem.

Researchers from the University of Oxford found that people lost the most weight when obesity treatments were presented as good news and an ‘opportunity’, rather than emphasizing the negative consequences of obesity.

Patients are more likely to lose weight if their doctor gives advice in an optimistic tone – paying little attention to obesity, body mass index or weight as an issue

They were less likely to participate in the programs and lose weight if doctors emphasized the negative consequences of obesity or used neutral language.

Patient encounters were analyzed in 38 doctors’ practices in England, recording 87 GPs speaking to patients about a free 12-week weight loss programme.

Researchers assessed whether the language used during the appointment affected patient behavior, including program participation and weight loss outcomes.

These exchanges were then classified into three categories: ‘good news’, ‘bad news’ and ‘neutral’.

Those who used the good news approach communicated positively and optimistically, focused on the benefits of weight loss and presented the weight loss program as an opportunity.

These doctors made little mention of obesity, body mass index or weight as a problem, according to the findings published in the Annals of Internal Medicine.

Others highlighted the ‘problem’ of obesity – focusing on the challenges of weight management, with a delivery that conveyed regret and pessimism.

The neutral news service – the most observed – lacked positive or negative characteristics.

Those in the good news advice approach lost the most weight, with an average of 4.8kg in 12 months, compared to 2.7kg in the bad news group and 1.2kg among the neutral people.

Researchers suggested this was likely caused by a higher percentage of people enrolling in the 12-week weight-loss program: 87 percent, compared to less than half in the other groups.

They said the findings “could significantly change the way medical professionals approach conversations with patients.”

Dr. Charlotte Albury, lead author and researcher at the Nuffield Department of Primary Care Health Sciences at the University of Oxford, said this shows the importance of positivity.

She said: ‘What we found was that when doctors framed the conversation as ‘good news’ – emphasizing the benefits and possibilities of weight loss in a positive way – patients were more likely to enroll in a weight-loss program, attend more sessions, and , most importantly, losing more weight compared to neutral or negative framing.

‘We know words matter, and this research shows that they really do – in the short and long term.

“Overall, our research shows that subtle changes in communication can significantly impact patient outcomes a year later.

“The elements that constituted ‘good news’ were subtle, but had a clear and positive impact.”

WHAT SHOULD A BALANCED DIET LOOK LIKE?

Meals should be based on potatoes, bread, rice, pasta or other starchy carbohydrates, preferably whole grains, according to the NHS

• Eat at least 5 portions of varied fruit and vegetables every day. All fresh, frozen, dried and canned fruits and vegetables count

• Basic meals on potatoes, bread, rice, pasta or other starchy carbohydrates, preferably whole wheat

• 30 grams of fiber per day: This is the same as eating all of the following: 5 servings of fruits and vegetables, 2 whole-grain cereal cookies, 2 thick slices of whole-grain bread, and a large baked potato with the skin still on

• Provide some dairy or dairy alternatives (such as soy drinks), opting for lower fat and lower sugar options

• Eat some beans, legumes, fish, eggs, meat and other proteins (including 2 portions of fish per week, one portion of which is fatty)

• Choose unsaturated oils and spreads and consume them in small quantities

• Drink 6-8 cups/glasses of water per day

• Adults should have less than 6 grams of salt and 20 grams of saturated fat for women or 30 grams for men per day

Source: NHS Eatwell guide

University of OxfordWeight Loss

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