title: Predictors of weight loss communication in primary care encounters.
abstract: OBJECTIVE
  Evidence suggests that physicians' use of motivational interviewing (MI) techniques helps patients lose weight. We assessed patient, physician, relationship, and systems predictors of length of weight-loss discussions and whether physicians' used MI techniques.
  
  
  METHODS
  Forty primary care physicians and 461 of their overweight or obese patients were audio recorded and surveyed.
  
  
  RESULTS
  Weight-related topics were commonly discussed (nutrition 78%, physical activity 82%, and BMI/weight 72%). Use of MI techniques was low. A multivariable linear mixed model was fit to time spent discussing weight, adjusting for patient clustering within physician. More time was spent with obese patients (p=.0002), by African American physicians (p=.03), family physicians (p=.02), and physicians who believed patients were embarrassed to discuss weight (p=.05). Female physicians were more likely to use MI techniques (p=.02); African American physicians were more likely to use MI-inconsistent techniques (p<.001).
  
  
  CONCLUSIONS
  Primary care physicians routinely counsel about weight and are likely to spend more time with obese than with overweight patients. Internists spend less time on weight. Patient and systems factors do not seem to influence physicians' use MI techniques.
  
  
  CONCLUSIONS
  All physicians, particularly, male and African American physicians, could increase their use of MI techniques to promote more weight loss among patients.
authors.affiliation: Duke University Medical Center, Durham, NC, USA. polla007@mc.duke.edu
authors.forename: Kathryn I
authors.initials: KI
authors.lastname: Pollak
authors.forename: Cynthia J
authors.initials: CJ
authors.lastname: Coffman
authors.forename: Stewart C
authors.initials: SC
authors.lastname: Alexander
authors.forename: Justin R E
authors.initials: JR
authors.lastname: Manusov
authors.forename: Truls
authors.initials: T
authors.lastname: Ostbye
authors.forename: James A
authors.initials: JA
authors.lastname: Tulsky
authors.forename: Pauline
authors.initials: P
authors.lastname: Lyna
authors.forename: Iguehi
authors.initials: I
authors.lastname: Esoimeme
authors.forename: Rebecca J Namenek
authors.initials: RJ
authors.lastname: Brouwer
authors.forename: Rowena J
authors.initials: RJ
authors.lastname: Dolor
mesh_terms: D000328:Adult; D000368:Aged; D003142:Communication; D003376:Counseling; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010817:Physician-Patient Relations; D010821:Physicians, Family; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care / Q000458:organization & administration; D012737:Sex Factors; D012959:Socioeconomic Factors; D013637:Tape Recording; D013997:Time Factors; D014481:United States; D015431:Weight Loss