Researchers confirm doctors can be unscientific about weight loss

In findings that will surely be stacked right next to “Yes, chicken soup is good for you,” findings published in Family Practice show that doctors often give obese patients very general, very ineffective advice about losing weight. The study notes that available information, even in scientific literature, is often “vague, superficial, and commonly not supported by scientific evidence.”

The research team collected 159 recorded consultations between general practitioners and obese patients living in the United Kingdom through the Brief Interventions for Weight Loss (BWeL) trial. They found that most of their advice consisted of “eat less, move more,” “change your lifestyle a bit,” or “reduce carbohydrates.” Only rarely did they ask what the patient had already done to lose weight.

While an earlier study notes that even small conversations with doctors are associated with some weight loss, these researchers report that not only do patients not like such simple advice but concluded that, were the patients to follow it, they would not lose weight.

While lasting weight loss is not impossible, the matter is more complicated than the conventional wisdom would imply. For much of the 1990s, the general understanding of weight loss was that if a person adjusted their diet and exercise routine such that they expended 3500 calories more than they took in by eating, they would lose one pound of weight. The rationale was that one pound of lipids has 3500 calories in it. Later research showed that the human body is not a matter of simple arithmetic. When a human stops eating or increases exercise, his or her body temperature drops, rendering metabolism more efficient.

Formal studies confirming matters of general knowledge not only weed out incorrect general knowledge. They also vindicate people whose contributions have been undervalued or dismissed. Medicine has considerable issues with fatphobia. So many obese individuals have felt shamed or ignored at the doctor’s office that they avoid seeking medical care.

The research was sponsored by the British Heart Foundation.

Read the full text in Family Practice.

Tremblet M, Poon AYX, Aveyard P, Albury C. What advice do general practitioners give to people living with obesity to lose weight? A qualitative content analysis of recorded interactions. Family Practice. December 13, 2022. https://doi.org/10.1093/fampra/cmac137