A taboo topic? How General Practitioners talk about overweight and obesity in New Zealand
Lesley Gray 1 , Maria Stubbe 1 , Lindsay Macdonald 1 , Rachel Tester 1 , Jo Hilder 1 , Anthony C. Dowell 1 2
+ Author Affiliations
- Author Affiliations
1 Department of Primary Health Care & General Practice, University of Otago, Wellington, New Zealand
2 Department of Obstetrics and Gynaecology, University of Otago, Wellington, New Zealand
Correspondence to: Lesley Gray, Department of Primary Health Care & General Practice, Te Tari Hauora Tūmatanui me te Mātauranga Rata Whānau, School of Medicine and Health Sciences, University of Otago, Wellington, PO Box 7343, Wellington, New Zealand. Email: lesley.gray@otago.ac.nz
Journal of Primary Health Care 10(2) 150-158 https://doi.org/10.1071/HC17075
Published: 9 May 2018
Journal Compilation © Royal New Zealand College of General Practitioners 2018.
This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Abstract
INTRODUCTION: Obesity is overtaking tobacco smoking in New Zealand as the leading potentially modifiable risk to health. International obesity guidelines recommend that health professionals opportunistically encourage weight management with their patients. However, research shows consistently low rates of weight management discussion, suggesting that health professionals may not be realising their full potential to address obesity.
AIM: To identify communication strategies used by General Practitioners (GPs) to open the topic of weight and weight management in routine consultations.
METHODS: A secondary analysis was conducted of 36 video-recorded consultations in general practices, selected for relevance from a database of 205 consultations. Content and interactional analysis was conducted in the context of the entire consultation.
RESULTS: The topic of weight was initiated more often by GPs than patients and was raised mostly once or twice in a consultation and occasionally as many as six times. GPs employed opportunistic strategies twice as often as they used structured strategies.
DISCUSSION: This study of naturally occurring consultations confirmed GPs do engage in opportunistic discussions about weight. However, such discussions are challenging and interactionally delicate. Highlighting the clinical relevance of weight appears to be effective. The high frequency of patient contact with GPs provides opportunity to reach and work with people at risk of chronic conditions associated with excess weight. Further research is required to identify suitable training and brief intervention tools for use in routine consultations that may be beneficial for both GPs and patients.
KEYWORDS: General Practitioner; health research; obesity; weight management
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