50: Primary Care Physicians’ Discussions of Weight-Related Topics with Overweight Adolescents: Results from the Teen Chat Pilot Study

Abstract

Physicians have been charged with treating overweight adolescents through counseling to lose weight, improve nutrition, and increase physical activity. This report explores how weight-related topics are discussed and physician predictors of how weight-related topics are discussed. This observational study was conducted in academic medical center affiliated pediatric and family medicine practices. We surveyed and audio recorded 30 encounters with practicing physicians and their at-risk and overweight male and female adolescent patients. We coded weight-related discussions and adherence to Motivational Interviewing (MI) skills. We examined whether physician characteristics were related to MI skills and also tested correlations of MI skills with adolescent patients’ changes in fat intake, physical activity, screen time, and self-reported weight one month after the visit. Weight-related topics were routinely addressed (28 of 30 visits). When addressed, the topics were almost always initiated by physicians (90% of time). Female physicians (p = 0.02), physicians with lower BMIs (p = 0.003), and pediatricians compared to family physicians (p = 0.02) were more likely to use MI skills. When physicians used MI skills, patients were more likely to increase their minutes of moderate physical activity (p = 0.05) and report weight loss (p = 0.03) one month after the visit. No associations were found for fat intake or screen time. MI skills may improve patients adherence to recommendations related to physical activity and weight loss. Physicians, particularly male, family physicians, and those with higher BMIs, may benefit from communication training to help adolescent patients change their behaviors.