How a doctor counsels patients on weight loss may make a difference in pounds lost

Going to see the doctor for a checkup usually includes a chat about diet and exercise, especially if the patient is overweight. But those talks may not have any influence on shedding pounds, says a new study -- unless the doctor was motivating and empathetic.

Conversations between 40 primary care physicians and 461 of their overweight or obese patients were recorded by researchers who wanted to see if weight was mentioned by the doctor and, if so, in what manner. Overall, doctors talked about weight in 69% of appointments, and that conversation took up an average 3.5 minutes, or 15% of a typical 20-minute visit. Less than half of the doctors (38%) said they’d been trained in behavioral counseling.

However, three months following the appointments, there was no difference in weight seen among patients who had a talk about weight with their doctors and those who didn’t.

But researchers noticed a difference when they separated doctors who counseled their patients on weight into two groups: Those who used motivational techniques and those who had a more judgmental and confrontational style. Three months down the road, patients of doctors who had a more empathetic communication style had lost an average 3.1 pounds, while patients of doctors who were more critical gained an average 0.4 pounds.

“Patients don’t like to be told what to do, and they are generally not going to question or talk back to their doctor,” said Kathryn Pollak, lead author of the study, in a news release. The member of the Cancer Prevention Program in the Duke Comprehensive Cancer Center added, “But what happens when doctors use reflective statements or a more motivational and empathic approach, it changes the relationship; the patient becomes more of an equal, more of a partner in care.”

In the study, the authors wrote, “When physicians discuss weight in a way that is collaborative, supports patient autonomy and allows the patient to be the driver of change, the patient may be more likely to change.”

The study appears in the October issue of the American Journal of Preventive Medicine.

-- Jeannine Stein / Los Angeles Times