Women weigh in: obese African American and White women's perspectives on physicians' roles in weight management.

Background: There is little qualitative research on the type of weight loss counseling patients prefer from their physicians and whether preferences differ by race.

Methods: This qualitative study used semistructured, in-depth interviews of 33 moderately to severely obese white and African American women to elucidate and compare their perceptions regarding their primary care physician's approach to weight loss counseling. Data were analyzed using a grounded theory approach and a series of immersion/crystallization cycles.

Results: White and African American women seemed to internalize weight stigma differently. African American participants spoke about their pride and positive body image, whereas white women more frequently expressed self-deprecation and feelings of depression. Despite these differences, both groups of women desired similar physician interactions and weight management counseling, including (1) giving specific weight loss advice and individualized plans for weight management; (2) addressing weight in an empathetic, compassionate, nonjudgmental, and respectful manner; and (3) providing encouragement to foster self-motivation for weight loss.

Conclusion: While both African American and white women desired specific strategies from physicians in weight management, some white women may first need assistance in overcoming their stigma, depression, and low self-esteem before attempting weight loss.