Discussing Weight in Real World GP Consultations: A Video Recording Analysis Study.

Objective: GPs have a complex role in obesity management due to patients' individualized experience of living with obesity, coupled with the challenge to deliver healthcare messages in non-stigmatizing ways. This study aimed to explore who initiates the topic of weight and how weight was discussed in real-world GP-patient consultations. Method: A multi-disciplinary team, including obesity lived experience experts, undertook a secondary data analysis of 43 Australian video recorded consultations and patient surveys from The Digital Library using descriptive content analysis. Results: 17/43 consultations included the topic of weight in the discussion. 15 were initiated by the GP and 2 by the patient. 14/17 used a structured approach. All GPs asked for consent to discuss weight or gave patients space to decline the discussion. No overt stigmatizing language was identified. A post-consultation survey found 15/17 patients (2 unanswered) felt listened to and respected during consultations. Conclusion: This study identified the intricate ways GPs approach weight discussions in consultations. GPs navigated weight discussions in ways that made patients feel respected and listened to and related weight to health concerns relevant to each patient. Practice Implications: The findings in this study can serve as a foundation for establishing education and training resources for GPs and can be utilized as a way of continuing professional development. Any future communication technique resources for GPs should be co-designed with obesity lived experience experts to ensure appropriateness and avoid potential stigma and harm.