Counseling overweight in primary care: an analysis of patient-physician encounters.

Objective: The aim of this study was to assess general practitioners' (GPs') and patients' practices and attitudes regarding overweight encountered during preventive counseling talks.

Methods: Twelve GPs audiotaped their preventive counseling talks with overweight patients, including the assessment of individual risk profiles and further medical recommendations. Fifty-two dialogues were transcribed and submitted to qualitative content analysis.

Results: Dietary advice and increased physical activity are mostly discussed during talks. Recommendations appear to be more individual if patients are given the chance to reflect on causes of their overweight during counseling talks.

Conclusions: A dialogue approach affects the strength and quality of weight loss counseling in primary care. However, physicians and overweight patients rarely agreed on weight loss goals during the physician-patient talks.

Practical Implications: Patient centeredness, particularly the integration of patients' perceptions towards weight management, might be an important step towards improving weight counseling in primary care.