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Obese patients are the most likely to disagree with doctors when given lifestyle advice

A GP measures the waist of an obese patient - ADAM GAULT/SPL/Science Photo Library RF
A GP measures the waist of an obese patient - ADAM GAULT/SPL/Science Photo Library RF

Obese patients are the most likely to disagree with their doctors when given lifestyle and weight loss guidance, a study has found.

Researchers found patients tend to associate excess weight with factors that they cannot control, such as genetics and hormones.

Doctors, on the other hand, tend to attribute it to controllable factors, such as diet and physical activity.

Dr Laëtitia Gimenez, the lead author, said: "These disagreements could degrade the quality of the patient-physician relationship.

"Our study provides an opportunity for GPs to reflect on how they communicate with overweight and obese patients, particularly with regard to lifestyle and weight-related advice and interventions taking into account the patient's representations."

The study, by the University of Toulouse and published in the journal Family Practice, investigated whether the interactions between 27 GPs and 585 patients varied according to the patient's body mass index (BMI).

Researchers analysed the level of their disagreement on information and advice given during consultations.

They found the greater the doctor-patient disagreement, the more overweight the patient was, with differences of opinion particularly pronounced for advice given by doctors on weight and lifestyle issues.

Compared to patients with a "normal" BMI, overweight patients were more likely to disagree with their doctors regarding advice given on weight loss, doing more physical activity and nutrition.

One in four British adults and around one in five children aged 10 to 11 are estimated to be obese, according to the NHS.

Professor Paul Aveyard, a professor of behavioural medicine at the University of Oxford who advises NHS England on obesity, told The Telegraph: "Both the patients and the doctors are correct. It's due to diet and physical activity and it's due to factors which are at least not easily controlled by the individual, which are things like genes.

"What genes do is determine your appetite, which determines how much you eat."

He said counteracting genetically influenced behaviours while being bombarded by adverts for food "requires continued effort".

The obesity prevention expert and GP, who has written a highly critical article in the British Journal of General Practice on doctors' "neglect" of the one in four of us who are obese, said many doctors "ignore" patients' weight issues by doing no more than weigh them every year.

Tam Fry, the chairman of the National Obesity Forum, added: "Stand-offs between overweight patients and their doctors are not just a problem in France. Family Practice must have published the research because similar disagreements are prevalent here.

"UK GPs are consistently advised by their Colleges about how to conduct consultations about weight issues. They are crucial conversations which, sadly, many GPs still fail to master."

It comes as calorie-counting on menus could be scrapped for medium-sized businesses under plans to rip up red tape.

The Government is looking at expanding what counts as a small to medium-sized enterprise (SME) to release more companies from the "clutches" of different types of regulation from which SMEs are exempt.

Kwasi Kwarteng, the Chancellor, said tax cuts must come with radical reforms to improve Britain's trend growth rate when he unveiled his mini-Budget on Friday.

The Telegraph understands that ministers have been looking at raising "de minimis" regulation thresholds, whereby red tape does not apply to companies below a certain size.

Liz Truss, the prime minister, is meanwhile preparing to scrap sugar taxes on soft drinks and some anti-obesity measures to ease the cost-of-living crisis in the country, according to a report in the Times.

Mr Kwarteng has ordered health officials to review obesity control measures, a move that is likely to result in the removal of many of them.

The NHS website states: "It's very important to take steps to tackle obesity because, as well as causing obvious physical changes, it can lead to a number of serious and potentially life-threatening conditions."

These included type 2 diabetes; coronary heart disease; some types of cancer, such as breast cancer and bowel cancer; and stroke.

According to figures from Diabetes UK, in 2021 almost 4.1 million people were living with a diagnosis of any type of diabetes.