When doctors advise patients to lose weight, an optimistic approach is more likely to get results.

Researchers found that patients were more likely to participate in the recommended program and shed pounds if doctors presented obesity treatments as an “opportunity.” They compared that upbeat approach to emphasizing the negative consequences of obesity or using neutral language. 

International guidelines recommend that primary care doctors screen patients and offer treatment for those who are overweight or obese. Patients have said that clinicians’ words and tone matter to them.

For this study, a University of Oxford team analyzed recordings of doctor-patient conversations at 38 primary care clinics about a free, 12-week behavioral weight-loss intervention. The researchers were looking for relationships between language used in the visit and patient behaviors, such as participation in the program and weight loss outcomes.

The authors characterized these interactions in three ways.

The “good news” approach was the least common. It communicated positivity and optimism, focused on the benefits of weight loss and presented the program as an opportunity.

In that approach, doctors made little mention of obesity, weight or body mass index (an estimate of body fat based on height and weight) as a problem. The information was presently smoothly and quickly, and conveyed excitement.

The “bad news” approach emphasized the “problem” of obesity. Physicians asserted themselves as experts. They focused on challenges of weight control and conveyed that with regret and pessimism.

The “neutral” news delivery, which the researchers saw most often, sounded neither positive nor negative.

Patients who received counseling using the good news approach had the highest observed weight loss at the end of a year. On average, they lost about 10.6 pounds compared to 6 pounds in the bad news group and 2.6 in the neutral news group.

Greater weight loss in the good news group appeared to be driven by higher enrollment in the 12-week weight-loss program. About 87% of people who received the positive talk attended compared with fewer than half of those in the other groups.

Participants’ weight-loss outcomes did not vary substantially, regardless of how the initial counseling was delivered.

Study findings were published Nov. 6 in Annals of Internal Medicine.

More information

The World Health Organization has more on obesity.

SOURCE: Annals of Internal Medicine, news release, Nov. 6, 2023