Most patients would have something to say about how doctors speak to them – and not all of it flattering. Intuitively, we’d say good communication gets better results than bad. And fascinating research illustrates how doctors talk to patients with obesity can have a significant impact on their weight-loss success.
This first-of-its-kind Oxford study shows not only that words matter, they matter over the short and long-term. This research is badly needed as doctor interviews get successful results in only five out of 100 patients.
The researchers analysed 246 recordings of doctor-patient conversations and found that subtle aspects of communication, such as word choice and tone of voice, influenced outcomes. It suggests doctor training on compassionate communication could help weight-loss efforts.
The research is timely, coming as it does when obesity treatment guidelines encourage doctors to discuss weight loss with patients and offer them referrals to weight-loss services if appropriate. But since only 5% of patients do take up a referral, this gap between policy and practice calls for better doctor communication, which is often hampered by a desire not to cause offence.
The study looked into recordings from a larger clinical trial where doctors offered patients a referral to a 12-week weight-loss programme. Using “conversation analysis”, the researchers identified how words and tone of voice could affect obesity care.
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They identified three main approaches doctors took: discussing the referral offer as “good news”, “bad news”, or neutrally. They then analysed which conversation approach led to patients agreeing to attend the programme, actually attending, losing weight, and being satisfied.
Only 50% of people attended weight-loss programmes which were offered in a neutral way, but if offered as “good news”, 83% attended, and lost half a stone more (or 3.6kg).
Lead author, Oxford’s Dr Charlotte Albury, said: “What we found was that when doctors framed the conversation as ‘good news’ – emphasising the benefits and opportunities of weight-loss in a positive manner – patients were more likely to enrol in a weight-loss programme, attend more sessions, and, importantly, lose more weight compared to a neutral or negative framing.”
The researchers urge doctors and other medical professionals to adopt the “good news” approach in their communications with patients living with obesity.
By presenting weight-loss help positively and as an opportunity, they can significantly boost patients’ motivation. Through turning conversations into constructive dialogues, patients can be empowered to achieve healthier lifestyles.
More good news, please.
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