Physician communication techniques and weight loss in adults: Project CHAT.
BACKGROUND
Physicians are encouraged to counsel overweight and obese patients to lose weight.


OBJECTIVE
It was examined whether discussing weight and use of motivational interviewing techniques (e.g., collaborating, reflective listening) while discussing weight predicted weight loss 3 months after the encounter.


METHODS
Forty primary care physicians and 461 of their overweight or obese patient visits were audio recorded between December 2006 and June 2008. Patient actual weight at the encounter and 3 months after the encounter (n=426); whether weight was discussed; physicians' use of motivational interviewing techniques; and patient, physician, and visit covariates (e.g., race, age, specialty) were assessed. This was an observational study and data were analyzed in April 2009.


RESULTS
No differences in weight loss were found between patients whose physicians discussed weight or did not. Patients whose physicians used motivational interviewing-consistent techniques during weight-related discussions lost weight 3 months post-encounter; those whose physician used motivational interviewing-inconsistent techniques gained or maintained weight. The estimated difference in weight change between patients whose physician had a higher global motivational interviewing-Spirit score (e.g., collaborated with patient) and those whose physician had a lower score was 1.6 kg (95% CI=-2.9, -0.3, p=0.02). The same was true for patients whose physician used reflective statements: 0.9 kg (95% CI=-1.8, -0.1, p=0.03). Similarly, patients whose physicians expressed only motivational interviewing-consistent behaviors had a difference in weight change of 1.1 kg (95% CI=-2.3, 0.1, p=0.07) compared to those whose physician expressed only motivational interviewing-inconsistent behaviors (e.g., judging, confronting).


CONCLUSIONS
In this observational study, use of motivational interviewing techniques during weight loss discussions predicted patient weight loss.
Pollak
Kathryn I
KI
Cancer Prevention, Detection and Control Research Program, Duke University Medical Center, Durham, North Carolina, USA. kathryn.pollak@duke.edu
Alexander
Stewart C
SC
Coffman
Cynthia J
CJ
Tulsky
James A
JA
Lyna
Pauline
P
Dolor
Rowena J
RJ
James
Iguehi E
IE
Brouwer
Rebecca J Namenek
RJ
Manusov
Justin R E
JR
Østbye
Truls
T
D000368:Aged; D003142:Communication; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007407:Interviews as Topic / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009765:Obesity / Q000523:psychology* / Q000628:therapy; D050177:Overweight / Q000523:psychology* / Q000628:therapy; D010817:Physician-Patient Relations; D015431:Weight Loss