Background: There is limited research on how patients prefer physicians to communicate about the topic of obesity, and there is even less understanding of which terms physicians most commonly use.Methods: In this cross-sectional, nonrandom sampling study, patients who were seeking treatment for weight loss rated the desirability of 12 terms to describe excess weight, and physicians rated the likelihood with which they would use those terms during clinical encounters. Participants rated terms on a 5-point scale, with ؊2 representing "very undesirable" or "definitely would not use" and ؉2 representing "very desirable" or "definitely would use."Results: Patients (n ‫؍‬ 143; mean age, 46.8 years; mean body mass index, 36.9 kg/m 2 ) rated "weight" (mean ؎ SD) as the most desirable term (1.13 ؎ 1.10), although it did not significantly differ from 5 other terms provided. They rated "fatness" (؊1.30 ؎ 1.22) as the most undesirable term, although this rating did not differ significantly from 4 other terms. Physicians affiliated with a community-based medical school (n ‫؍‬ 108; mean age, 48.8 years; 79.6% primary care specialty) were most likely to use "weight" (1.42 ؎ 0.89), which was significantly different from ratings for all other terms. They were least likely to use "fatness" (؊1.74 ؎ 0.59), although this rating did not differ significantly from 3 other terms.Conclusion: Physicians generally reported that they use terminology that patients had rated more favorably, and they tend to avoid terms that patients may find undesirable. Understanding the preferences and terminology used by patients and physicians is an important initial step to ensure that communications related to obesity and weight loss are efficient and effective. The provision of weight loss counseling by physicians in primary care settings offers a potentially effective approach to combating the problem of overweight and obesity.1-4 However, physicians often neglect broaching the topics of obesity and weight loss during primary care encounters. 3,[5][6][7][8] Barriers that may hinder physicians' provision of weight-loss counseling include time constraints, lack of reimbursement, and perceptions that treatment will be ineffective. In addition, physicians may feel ill-equipped to address these issues. 5,9 -12 Despite these barriers, overweight and obese patients may desire greater involvement of their primary care physician in weight-loss counseling and treatment efforts. 6,7 Until recently, however, few studies have examined how patients would prefer their physicians to discuss the topic of obesity. In one study, obese patients rated the term "weight" as significantly more desirable than a variety of terms physicians could use to describe excess weight; they rated "obesity," "excess fat," and "fatness" as the most undesirable terms physicians could use. 13 The parents of pediatric patients overwhelmingly preferred that physicians use the phrase "gaining too much weight" as compared with other options, including "overweight," when discussing their chi...

Background A variety of physician and patient characteristics may influence whether weight loss counseling occurs in primary care encounters. Objectives This study utilized a cross-sectional survey of primary care patients, which examined patient characteristics, physician characteristics, and characteristics of the physician-patient relationship associated with weight loss counseling and recommendations provided by physicians. Participants Participants (N=143, mean age=46.8 years, mean BMI=36.9 kg/m2, 65% Caucasian) were overweight and obese primary care patients participating in a managed care weight loss program. Measures Participants completed self-report surveys in the clinic prior to the initial weight loss session. Surveys included items assessing demographic/background characteristics, weight, height, and a health care questionnaire evaluating whether their physician had recommended weight loss, the frequency of their physicians’ weight loss counseling, and whether their physician had referred them for obesity treatment. Results Patient BMI and physician sex were most consistently associated with physicians’ weight loss counseling practices. Patients seen by female physicians were more likely to be told that they should lose weight, received more frequent obesity counseling, and were more likely to have been referred for obesity treatment by their physician. Length and frequency of physician-patient contacts were unrelated to the likelihood of counseling. Conclusions These findings add to previous evidence suggesting possible differences in the weight loss counseling practices of male and female physicians, although further research is needed to understand this potential difference between physicians.

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