Oral Presentation Australian and New Zealand Obesity Society Annual Scientific Conference 2024

Discussing weight with patients in primary care: A mixed methods experimental study. (#28)

Madeline L West 1 , Joanne A Rathbone 2 , Maria Bilal 3 , Anne Nileshni Fernando 1 , Gemma Sharp 1
  1. Department of Neuroscience, Monash University, Melbourne, Victoria, Australia
  2. School of Medicine and Psychology, Australian National University, Canberra, ACT, Australia
  3. Macarthur Diabetes, Endocrinology and Metabolism Service, Campbelltown Hospital , Campbelltown, NSW, Australia

Weight bias is characterised by negative attitudes towards people with a higher weight (1) and is widespread in healthcare (2). Primary care professionals may avoid discussing weight with patients due to concerns about upsetting them, insufficient training, resources, or referral pathways. However, addressing the health needs of patients may require primary care professionals to discuss weight. The current study aimed to understand primary care professionals’ perceptions of the appropriateness of weight-centric, weight-inclusive/holistic, and avoidant approaches in clinical contexts where patients with higher weights were and were not seeking weight management advice.

The study had a mixed methods design and included primary care professionals (N = 112) within Australia. Participants completed an online survey and provided demographic data and completed measures of implicit and explicit weight bias. Professionals viewed simulated patient consultations, reflecting each of the three approaches (weight-centric, weight-inclusive/holistic, and avoidant) in a weight-related and non-weight related context. Participants then evaluated the appropriateness of the language and strategies used.

The primary care professionals showed, on average, low levels of explicit weight bias but high levels of implicit weight bias. For the consultations, language and strategies of the holistic approach were considered the most appropriate in both contexts (all Ps < 0.001). In the weight-related consultation, language used in the weight-centric and avoidant approaches were deemed equally inappropriate (P = 0.66). However, weight-centric strategies were considered more appropriate than avoidant strategies (P < 0.001). In the non- weight related consultation, the language and strategies of the avoidant approach were considered more appropriate than those of the weight-centric approach (all Ps < 0.001). Primary care professionals favoured the holistic approach to discussing weight when patients presented with weight-related or non-weight related concerns. These findings have potential practical implications for health professional education.

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