- Researchers report that advice on weight loss given to people with obesity by their doctors tends to be vague and not helpful.
- They say that doctors often just tell people to eat less and exercise more.
- Experts say specific, individualized approaches to weight loss are the most effective.
When doctors tell people with obesity to lose weight, their advice is often vague or general in nature and not always supported by science.
That’s according to a study published today in the journal Family Practice.
In it, researchers say that in the majority of cases, advice given to patients was abstract or superficial with little practical advice.
“This research demonstrates that doctors need clear guidelines on how to talk opportunistically to patients living with obesity about weight loss,” said Madeleine Tremblett, PhD, lead author of the study and a qualitative researcher at the Nuffield Department of Primary Care Health Sciences at the University of Oxford in England, in a press release.
“This can help them to avoid amplifying stigmatizing stereotypes and give effective help to patients who want to lose weight,” she added.
The researchers from Oxford examined 159 audio recordings of consultations between people with obesity and general practitioners.
They found that in the consultations, the advice given by doctors rarely included effective methods for weight loss and in the majority of cases involved telling patients just to eat less and exercise more.
Lauri Wright, PhD, the director of the University of North Florida Center for Nutrition and Dietetics and president-elect of the Academy of Nutrition and Dietetics, says the findings aren’t surprising.
“Working in a hospital for over a decade, you understand that healthcare in our country is disease-focused rather than prevention-focused,” she told Healthline. “There is so much that has to be taught in medical school that many don’t even offer nutrition in the curriculum. Additionally, physicians in practice are rarely given the time to counsel patients on behavioral and lifestyle changes.”
The researchers reported that superficial advice was common, with suggestions such as a person needing to “change their lifestyle a bit.” Only 20% of the consultations saw doctors give patients advice on how to carry out weight loss.
The researchers found that when doctors did offer specific advice relating to weight loss, it was often not backed by science and was unlikely to result in real weight loss. Advice such as making small changes in behavior and taking the stairs more aren’t backed by research, the researchers said.
Dr. Kurt Hong, an internal medicine expert who specializes in obesity, metabolic diseases, and other nutrition disorders at Keck Medicine of USC in California, says the advice given to patients needs to be practical.
“You don’t get somebody who is not exercising to go from zero to exercising to five times a week. Whereas if you tell them to start with once or twice a week… when they feel like it’s actually in their control, they’re more likely to do it,” he told Healthline.
“When it comes to specific recommendations it’s not about what is ideal, it’s about what is practical. When it comes to diet, unfortunately, there is a lot of bad information out there,” Hong added. “There are some physicians who they feel like the only way you can lose weight is to go on the ketogenic diet or you have to cut out all carbs. We know nowadays, that’s absolutely not true. You can have a lot of healthy carbs, as long as you’re able to be selective making sure you avoid some of the processed carbohydrates and added sugar.”
Experts say that even a brief conversation with a doctor about weight management can be effective.
However, doctors report a number of barriers to having a conversation. They include being unsure of the best advice to give and a lack of knowledge about effective weight loss strategies.
The researchers identified that a common myth when it came to weight loss was that patients needed the “right mindset” to lose weight.
Dr. Michelle Hauser, the obesity medicine director of the Medical Weight Loss Program in the Stanford Lifestyle and Weight Management Center in California, says this kind of language is problematic.
“There’s a huge issue with obesity bias, this idea that it’s someone’s choice that they have extra weight or have obesity, and it really is classified as a disease. Like heart disease is a disease or cancer is a disease, obesity is a disease,” she told Healthline. “We wouldn’t expect people to just have the right mindset and treat their heart disease or cancer. Equally so we should use science and research and evidence-based treatments for obesity, just like we would anything else.”
When it comes to practical advice for losing weight, the experts who spoke with Healthline say an individualized approach is required that considers the circumstances of the person who has obesity.
“You don’t become obese overnight and you can’t lose all the weight overnight either. Obesity is multifactorial and just following a restrictive diet alone isn’t very effective,” Wright said.
“To be successful, you have to identify the factors that contribute to weight gain and help the patient restructure the behaviors to achieve a healthy weight. That ideal scenario would combine nutritional counseling and education with behavior modification and lifestyle change,” Wright added.