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Positivity needed to reduce the bulge

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Doctors who approach overweight and obese patients about their weight compassionately and without making them feel judged, are more likely to see their patients achieve weight loss.

Researchers from Johns Hopkins University found that overweight and obese patients who feel their doctor is negatively judging their weight are more likely to try and reduce their waistlines, but are less likely to succeed.

Lead researcher Assistant Professor Kimberly Gudzune said that negative encounters can prompt a weight loss attempt, but the study shows that they do not translate into success.

“Ideally, we need to talk about weight loss without making patients feel they are being judged. It’s a fine line to walk, but if we can do it with sensitivity, a lot of patients would benefit,” Assistant Professor Gudzune said.

Assistant Professor Gudzune and her team set out to test whether the negative attitudes and weight stigma from some primary care doctors was limiting the effectiveness of advice given to obese and overweight patients.

The researchers surveyed more than 600 people with a body mass index of 25 or more and who regularly visited their GP. Participants were asked to identify if they had felt their doctor judged them in the past 12 months because of their weight. More than 20 percent of participants said they believed they had been judged.

Further, 96 per cent of those who felt they had been judged had tried to lose weight in the previous year, compared with 84 per cent of patients who didn’t feel judged.

However, only 14 per cent of those who felt judged and had discussed weight loss with their doctor lost 10 per cent or more of their body weight, while 20 per cent of patients who didn’t feel judged and also discussed weight loss with their GP lost a similar amount.

The study found that talking with their doctor about weight loss helped people lose more weight. Only nine per cent of those who felt judged but did not see their doctor lost more than 10 per cent of their body weight, and six per cent of those who did not feel judged and who did not see their doctor lost weight.

Assistant Professor Gudzune said overall, only two-thirds of participants said that their doctors brought up weight loss.

“Many doctors avoid the conversation because they don’t want to make anyone feel bad, worrying they’ll create a rift with their patients if they even bring it up,” Assistant Professor Gudzune said. “But that is not in the patients’ best interest in terms of their long-term health.”

Assistant Professor Gudzune said it is helpful to start with small weight loss steps, such as a 10 per cent reduction in weight. A longer-term goal of losing 30 to 50 kilograms can be a setup for frustration and failure when tackled all at once.

“We don’t want to overwhelm them,” Assistant Professor Gudzune said. “If we are advocates in this process, and not their critics, we can really help patients to be healthier through weight loss.”

The study was published in the journal Preventive Medicine.

Kirsty Waterford