ABC News December 13, 2022

People may not always get helpful weight loss advice from their doctors, study finds

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Maintaining a healthy weight has numerous health benefits, but primary care doctors may not always give specific, effective weight loss advice to their patients, according to a new study in Family Practice.

The study, which was led by researchers in the U.K., analyzed over 150 audio recordings from primary care visits, finding doctors often vaguely encourage patients to "eat less" or "do more" rather than recommending tried-and-tested weight loss strategies. Only 20% of visits included specific, actionable instructions for patients.

Although the study was based in the U.K., doctors say it has broad implications in the United States and beyond. In both countries, roughly two-thirds of adults are overweight or obese.

Dr. Selvi Rajagopal, an assistant professor of medicine and pediatrics who specializes in obesity medicine at Johns Hopkins University School of Medicine, said telling patients they need to lose weight by moving more or eating less is not helpful and can be harmful.

"It puts a lot of the blame on the patient. And it also gives them no really clear tangible action plan of what to do," Rajagopal told ABC News.

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The study authors suggest that more specific clinical guidelines on effective weight loss counseling would better support primary care doctors who are trying to help their patients lose weight.

The National Institute of Health encourages health care providers to partner with their patients who want to lose weight to make an individualized plan together, but a study in 2020 also found that primary care providers often said they have a lack of confidence in weight loss treatments and lack of knowledge about effective weight loss methods. Doctors also have a lot of time-constraints that can limit adequate patient counseling.

"There's just so little time. There are so many other tasks, [doctors] feel overwhelmed," Rajagopal said.

Research has shown that setting goals can be an effective weight loss method that health care providers can incorporate into patient visits. Weight loss goals should be specific, measurable, achievable, realistic and time-sensitive (S.M.A.R.T.) as opposed to advice that is too broad or vague.

Setting a specific time for a S.M.A.R.T. goal is key. For example, someone who is trying to consume fewer sugary beverages could aim to cut their intake by half over the next month.

Rajagopal also emphasized that doctors should provide specific, evidence-based guidance. Patients, however, know what weight loss goals are realistic and achievable for them.

"If it's something that just isn't within their bandwidth for whatever reason, whatever life circumstances, telling them to do something unachievable is not going to happen," said Rajagopal.

Jade A Cobern, MD, a board-eligible in pediatrics and MPH candidate, is a member of the ABC News Medical Unit and general preventive medicine resident at Johns Hopkins.