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Talking delicately: Providing opportunistic weight loss advice to people living with obesity

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posted on 2022-09-07, 09:18 authored by Madeleine Tremblett, Helena Webb, Sue Ziebland, Elizabeth Stokoe, Paul Aveyard, Charlotte Albury

Obesity is a major worldwide public health problem. Clinicians are asked to communicate public health messages, including encouraging and supporting weight loss, during consultations with patients living with obesity. However, research shows that talking about weight with patients rarely happens and both parties find it difficult to initiate. Current guidelines on how to have such conversations do not include evidence-based examples of what to say, when to say it and how to avoid causing offence (a key concern for clinicians). To address this gap, we examined 237 audio recorded consultations between clinicians and patients living with obesity in the UK in which weight was discussed opportunistically. Conversation analysis revealed that framing advice as depersonalised generic information was one strategy clinicians used when initiating discussions. This contrasted to clinicians who made advice clearly relevant and personalised to the patient by first appraising their weight. However not all personalised forms of advice worked equally well. Clinicians who spoke delicately when personalising the discussion avoided the types of patient resistance that we found when clinicians were less delicate. More delicate approaches included forecasting upcoming discussion of weight along with delicacy markers in talk (e.g. strategic use of hesitation). Our findings suggest that clinicians should not avoid talking about a patient's weight, but should speak delicately to help maintain good relationships with patients. The findings also demonstrate the need to examine communication practices to develop better and specific guidance for clinicians. Data are in British English.

Funding

Improving delivery of brief opportunistic advice for weight loss in primary care

British Heart Foundation

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UK National Prevention Research Initiative

A randomised controlled trial to test the effectiveness of a brief intervention for weight management for obese adults in primary care.

Medical Research Council

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History

School

  • Social Sciences and Humanities

Department

  • Communication and Media

Published in

SSM - Qualitative Research in Health

Volume

2

Issue

2022

Publisher

Elsevier

Version

  • VoR (Version of Record)

Rights holder

© The Authors

Publisher statement

This is an Open Access Article. It is published by Elsevier under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence (CC BY-NC-ND). Full details of this licence are available at: https://creativecommons.org/licenses/by-nc-nd/4.0/

Acceptance date

2022-08-24

Publication date

2022-08-30

Copyright date

2022

ISSN

2667-3215

Language

  • en

Depositor

Prof Elizabeth Stokoe. Deposit date: 29 August 2022

Article number

100162

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