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Ahh, the yearly physical. For some, a checkup with the primary care doc feels like no big deal. A few tests, some notes and a thumbs-up presented with “See you next year!”
But for millions of Americans—including most of the 42% of adults who fall under the umbrella of “obesity” by potentially inaccurate body mass index (BMI) standards—a doctor’s visit can be overflowing with uncomfortable moments.
We’re not throwing stones at doctors, and we know that many treat patients with compassion, targeted advice and in a body-neutral way. But that’s not the norm, according to a study published December 13, 2022, in the journal Family Practice. In it, the researchers say that in the majority of cases, doctors give patients weight-loss advice that’s more abstract than actionable, too vague to be beneficial, and not always supported by science.
Ahead, learn more about how the researchers landed at this conclusion, plus what the scientists say medical professionals—and those being consulted by them—should keep in mind.
Related: Why It’s Actually Rude to Compliment Someone’s Weight Loss, According to a Dietitian
What This Weight-Loss Study Found
A team of experts at the University of Oxford in England investigated 159 audio recordings of consultations between general practitioners and their patients who had BMIs within the ranges deemed “obese.” Superficial advice was common, including guidance that one person should “change their lifestyle a bit.” Only 20% of the appointments included doctors offering advice about how to actually accomplish the weight loss they were recommending. (P.S. Here are 3 key habits for actually maintaining weight loss, as that’s an important part of the conversation, too.)
Common suggestions included the following abstract tips, which aren’t actually backed by current science (and in some cases, are patently false):
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Eat less, move more
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Just take the stairs
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Be careful what you eat
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Reduce your carbs
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Use an app to track calories so you can monitor calories in and calories out
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Get as much exercise as your joints will allow
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Make your own gluten-free flour since it won’t have sugar (which is completely false; gluten is a protein, after all)
“Our analysis identifies that clinicians mostly do not provide effective advice, and so even if patients were to follow the advice, they would be unlikely to lose weight,” the researchers write in the journal, noting that the “eat less, do more” angle was the go-to fallback recommendation when other resources weren’t available.
Related: Study Finds Physical Activity, Not Weight Loss, Is Key to Reducing Health Risks
It’s definitely understandable why more tailored, nuanced advice is challenging to provide. Since our current medical system is treatment- and disease-centric rather than focused on prevention, very little time during the medical school curriculum is spent on nutrition and physical activity. This is another great reason why it’s important to consult experts specialized in these fields, like registered dietitians and physical therapists. Plus, doctors are often too short on time to really get to know their patients’ habits and other external factors that might impact overall well-being. (Say, access to a safe place to exercise or the need to work three jobs to pay the bills.) Not to mention, the research field is constantly evolving, and it can be daunting to keep up with the latest best practices in chronic disease prevention.
“Doctors need clear guidelines on how to talk opportunistically to patients living with obesity about weight loss,” Madeleine Tremblett, Ph.D., lead author of the study and a qualitative researcher at the Nuffield Department of Primary Care Health Sciences at the University of Oxford in England, says in a press release. “This can help them to avoid amplifying stigmatizing stereotypes and give effective help to patients who want to lose weight.”
The Bottom Line
A small study analyzing doctor conversations with patients reveals that much of the standard weight-loss advice is too vague to be useful and, occasionally, is totally inaccurate. It’s important to note that this is a tiny peek into medical offices in one country and at one point in time, and there are many doctors and other medical professionals who are connecting on a personal level and offering referrals to experts in nutrition, exercise and community advocacy.
While much more research is needed and larger conversations around the medical school curriculum—and health care industry strategy at large—are required, this research shines a spotlight on the need for more discourse about what can actually be supportive and fruitful for those seeking to lose weight.
Since obesity is multifactorial and simply adhering to a restrictive diet (for as long as you can hang on for dear life) isn’t effective, an individualized approach is best, the researchers say. Instead, they suggest a treatment strategy that includes:
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Nutrition counseling with a registered dietitian
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Behavior modifications focused on areas like stress management and sleep
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Lifestyle changes, including tailored physical activity advice
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Assistance with overcoming systemic barriers, such as food insecurity
