Primary care patient and practitioner views of weight and weight-related discussion: a mixed-methods study

Calum T McHale, Anita H Laidlaw, Joanne E Cecil

Research output: Contribution to journalReview articlepeer-review

11 Citations (Scopus)
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Objective: To understand the beliefs that primary care practitioners (PCPs) and patients with overweight and obesity have about obesity and primary care weight management in Scotland. Setting: Seven National Health Service (NHS) Scotland primary care centres. Participants: A total of 305 patients and 14 PCPs (12 general practitioners; two practice nurses) participated. Design and methodology: A cross-sectional mixed-methods study. PCPs and patients completed questionnaires assessing beliefs about obesity and primary care weight communication and management. Semi-structured interviews were conducted with PCPs to elaborate on questionnaire topics. Quantitative and qualitative data were synthesised to address study objectives. Results: (1) Many patients with overweight and obesity did not accurately perceive their weight or risk of developing weight-related health issues; (2) PCPs and patients reported behavioural factors as the most important cause of obesity, and medical factors as the most important consequence; (3) PCPs perceive their role in weight management as awareness raising and signposting, not prevention or weight monitoring; (4) PCPs identify structural and patient-related factors as barriers to weight communication and management, but not PCP factors. Conclusions: Incongruent and/or inaccurate beliefs held by PCPs and patient may present barriers to effective weight discussion and management in primary care. There is a need to review, standardise and clarify primary care weight management processes in Scotland. Acknowledging a shared responsibility for obesity as a disease may improve outcomes for patients with overweight and obesity.

Original languageEnglish
Article numbere034023
Number of pages10
JournalBMJ Open
Issue number3
Publication statusPublished - 9 Mar 2020

Bibliographical note

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.


  • primary care
  • qualitative research
  • public health
  • Obesity Management/methods
  • Awareness
  • General Practitioners/statistics & numerical data
  • Humans
  • Middle Aged
  • Overweight/epidemiology
  • Male
  • Case-Control Studies
  • Scotland/epidemiology
  • Adult
  • Female
  • Surveys and Questionnaires
  • Culture
  • Communication
  • Attitude of Health Personnel
  • Cross-Sectional Studies
  • Primary Health Care/organization & administration
  • Obesity/epidemiology
  • Health Behavior/physiology
  • Perception
  • Aged
  • National Health Programs/organization & administration
  • Patients/psychology


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