Excess weight increases the risk for many chronic diseases, including 11 cancers, but physicians may not bring up weight loss with their patients because they’re pressed for time, fear patients may be offended, or worry that bringing up weight loss won’t make much of a difference.
Now a new study published in The Lancet suggests that if primary care doctors take just 30 seconds to refer patients to a weight management program, physicians can help overweight and obese patients lose weight.
This trial involved 1,882 adult participants categorized as obese (a BMI of at least 30 or 25 if they were Asian) with an elevated body fat percentage. Participants were recruited from primary care office waiting rooms in the south of England and randomized to either a support or advice group.
In the support group, physicians spent 30 seconds at the end of the visit offering to refer participants to an effective weight management program. They made sure the patients who agreed had an appointment and encouraged patients to come back for another visit in four weeks to discuss their progress.
Forty percent of these individuals ended up attending the weight management group.
In the comparison intervention, physicians had the same 30 seconds to advise patients that weight loss would be beneficial to their health, but they did not refer them to a weight management program. Nine percent of this group ended up joining a weight management program on their own.
After a year, both groups lost weight, but patients in the support group lost about 3 pounds (1.4 kilograms) more compared to patients who received advice only.
Not only was the brief intervention effective, but 81% of all the participants found their physician’s weight loss support and advice both appropriate and helpful. Only 4 of the 1,882 participants found the intervention inappropriate and unhelpful, which should calm some physician’s fears.
Since this study took place in the United Kingdom, patients who were referred to a weight management program were able to attend for free through the National Health Service. In the United States, many patients would have to pay for weight management programs out-of-pocket, which could make them less likely to participate despite physician referrals. Also, 95% of the participants in this study were white, so the intervention should be tested with other demographic groups.
Nevertheless, physicians who want to support their patients’ weight loss can apply several strategies from this study to their visits:
- Address weight loss even if it is not the primary focus of the visit and time is limited: This study excluded participants who were already involved in a weight loss program or who were visiting their physician in order to discuss weight, but most participants were still receptive to attending a weight loss program: 77% agreed to the referral and 40% attended at least one session. Additionally, the intervention took only 30 seconds of the physician’s time.
- Offer specific actions that patients can take: Rather than providing general advice to lose weight, which could have left some participants feeling overwhelmed or unsure of what to do next, physicians implementing the active intervention offered a clear first step: attending a weight management program.
- Help participants take the first step: Making the weight management program appointment for patients before they left the physician’s office took an item off their to do list and may have encouraged them to follow through.
- Encourage accountability: Physicians asked patients to return in four weeks to discuss their progress. While most patients did not return, suggesting an appointment may have sent the message that the physician cared and would follow-up in the future.
The study was funded by the UK National Prevention Research Initiative.