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An analysis of directly observed weight communication processes between primary care practitioners and overweight patients

Research output: Contribution to journalArticle

Open Access Status

  • Embargoed (until 23/07/20)



To analyse weight-related communication prevalence and processes (content/context) between primary care practitioners (PCPs) and overweight patients within routine primary healthcare consultations.


Consultations between 14 PCPs and 218 overweight patients (BMI ≥25 kg/m2) were video recorded. Weight communication was coded using the Roter Interaction Analysis System (RIAS) and the novel St Andrews Issue Response Analysis System (SAIRAS). Communication code frequencies were analysed.


Weight discussion occurred in 25% of consultations with overweight patients; 26% of these had weight-related consultation outcomes (e.g. weight-related counselling and referrals, stated weight-related intention from patients). Weight discussions were more likely to occur if PCPs provided space to patient attempts to discuss weight (p = 0.013). Longer weight discussions (p < 0.001) and contextualising weight as problematic when PCP/patient-initiated weight discussion (p < 0.001) were associated with weight-related consultation outcomes.


Weight was rarely discussed with overweight patients, however PCP space provision to patient weight-discussion initiation attempts increased weight discussion. When weight was discussed, increased time and/or contextualising weight as a problem increased the likelihood of weight-related consultation outcomes.

Practical implication

PCP use of specific communication approaches when discussing, contextualising and responding to patient weight may facilitate weight-related discussion and consultation outcomes and could lead to more effective patient weight management.



Original languageEnglish
JournalPatient Education and Counseling
VolumeIn press
Early online date23 Jul 2019
Publication statusE-pub ahead of print - 23 Jul 2019

    Research areas

  • Overweight, Obesity, Direct observation, Primary healthcare, Weight management, Primary care communication, Weight-related communication, Communication coding

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ID: 253087045