Many doctors today are actually taking time out of their brief patient interactions to talk about weight loss. Given that most Americans are overweight or obese, this is a good thing. But, unfortunately, physician recommendations on behavior change aren't very effective unless delivered using certain techniques.

A recent study by researchers at Duke University Medical Center set out to determine whether the use of motivational interviewing (MI) techniques by physicians during weight-related conversations were related to weight loss 3 months after the encounter¹. Researchers audiorecorded 40 primary care physicians during 461 of their visits with overweight or obese patients. They listened for global ratings of empathy and MI techniques including evocation (eliciting patients' own reasons for change), collaboration (acting as partners), and autonomy (conveying that change comes only from patients). They also listened for behaviors like asking open-ended questions, reflecting back what patients say, asking for permission to give advice, and providing affirming and supportive statements.

Results showed that patients whose physician used MI techniques during weight-related discussions lost weight 3 months post-encounter (lost an average of 0.8 kg or 1.8 lbs). Patients whose physician used non-MI techniques like judging or confronting gained or maintained weight 3 months post-encounter (gained an average of 0.3 kg or 0.7 lbs). The higher the use of non-MI techniques by physicians, the lower the amount of weight loss was seen in patients.

The implications of this study reach far beyond just physicians. All health care providers or professionals working with the public on health behavior change (diet, exercise, weight loss) need to be educated on the most effective counseling, or coaching techniques. Telling patients/clients that they need to find a way to fit 150 minutes of moderate-intensity physical activity into their day isn't effective. But being empathetic and working with patients/clients on identifying reasons for becoming more active and breaking down barriers to physical activity is effective.

In this study only 38% of physicians reported prior training in behavioral counseling. Do you have the skills needed to help people effectively make and maintain changes to their lifestyle behaviors? If not, consider taking our Coaching Healthy Behaviors course.

"Just Do It" may work for selling shoes, but it doesn't work for changing behaviors!

¹Pollak, K.I. (2010). Physician communication techniques and weight loss in adults. American Journal of Preventive Medicine, 39(4), 321-328.