Journal of Primary Health Care Journal of Primary Health Care Society
Journal of The Royal New Zealand College of General Practitioners

Just Accepted

This article has been peer reviewed and accepted for publication. It is in production and has not been edited, so may differ from the final published form.

A Taboo topic? How General Practitioners talk about overweight and obesity in New Zealand

Lesley Gray , Maria Stubbe , Lindsay Macdonald , Rachel Tester , Jo Hilder , Tony Dowell


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 realizing the full potential to address obesity. AIM: To systematically identify communicative strategies used by New Zealand General Practitioners to successfully open the topic of weight and weight management in routine consultations. METHODS: A secondary analysis was conducted of 36 video-recorded consultations in New Zealand 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 the GP than the patient 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 utilized 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. CONCLUSION: The high frequency of patient contact with GPs provides significant 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.

HC17075  Accepted 28 January 2018

© CSIRO 2018