Patients more likely to lose weight if GPs frame options as ‘good news’ – study

People were less likely to sign up to weight-loss programmes when doctors talked about obesity in a negative way, researchers found.
People were less likely to lose weight if doctors emphasised the negative consequences of obesity or used neutral language, researchers said (Chris Radburn/PA)
PA Wire
Ella Pickover6 November 2023

Patients are more likely to lose weight if their doctor offers advice using an optimistic tone, researchers have said.

Academics said that people were more likely to participate in weight-loss programmes and lose weight successfully if medics presented treatments for obesity as good news and as an “opportunity”.

They were less likely to participate in the programmes and lose weight if doctors emphasised the negative consequences of obesity or used neutral language, according to a new study published in the Annals of Internal Medicine.

While anecdotal evidence suggests that the words and tone used by a doctor matter to patients and can motivate or demotivate weight loss, researchers from the University of Oxford said there was not enough good evidence on the best ways for doctors to discuss weight with their patients and the most effective ways of offering treatment.

When doctors framed the conversation as ‘good news’ ... patients were more likely to enrol in a weight-loss programme, attend more sessions, and, importantly, lose more weight compared to a neutral or negative framing

Lead author Dr Charlotte Albury

So they analysed patient encounters at 38 GP surgeries in England.

They listened to recordings of 87 different GPs and analysed the conversations these medics had with their patients regarding a free 12-week weight-loss programme.

The academics then assessed whether the language used in the appointment had an impact on patient behaviours, including participation in the programme and weight-loss outcomes.

The language of the doctor was categorised in three ways.

A “good news” approach, communicated positively and with optimism, focused on the benefits of weight loss, and presented the weight-loss programme as an “opportunity”, with very little mention of obesity, body mass index, or weight as a problem.

We know words matter, and this research shows they really do - in the short and long-term

Lead author Dr Charlotte Albury

The “bad news” approach emphasised the “problem” of obesity – medics who used this approach asserted themselves as the expert and focused on challenges of weight control, with a delivery that conveyed regret and pessimism.

The “neutral” news delivery, the most commonly observed, lacked either positive or negative features.

The researchers found that patients who received the “good news” counselling approach lost the most weight after a year.

People in the “good news” group lost an average of 4.8kg on average compared with 2.7kg among those in the “bad news” group and 1.2kg among those in the “neutral news” group.

The weight loss among the “good news” group appeared to be driven by a higher rate of people signing up to the 12-week weight-loss programme.

Overall, our research shows that subtle changes in communication can significantly influence patient outcomes one year later. The elements that constituted 'good news' were subtle but had a clear and positive impact

Lead author Dr Charlotte Albury

Some 87% of people in this group signed up to the programme, compared with less than half in the other groups.

Dr Charlotte Albury, lead author and researcher within the Nuffield Department of Primary Care Health Sciences at the University of Oxford, said: “What we found was that when doctors framed the conversation as ‘good news’ – emphasising the benefits and opportunities of weight loss in a positive manner – patients were more likely to enrol in a weight-loss programme, attend more sessions, and, importantly, lose more weight compared to a neutral or negative framing.

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

“Overall, our research shows that subtle changes in communication can significantly influence patient outcomes one year later. The elements that constituted ‘good news’ were subtle but had a clear and positive impact.”

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