British journal of health psychology
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Br J Health Psychol · Nov 2018
Initiating discussions about weight in a non-weight-specific setting: What can we learn about the interactional consequences of different communication practices from an examination of clinical consultations?
Effective clinical communication is fundamental to tackling overweight and obesity. However, little is known about how weight is discussed in non-weight-specific settings where the primary purpose of the interaction concerns clinical matters apparently unrelated to weight. This study explores how mental health clinicians initiate discussions about a patient's possible weight problem in the non-weight-specific setting of a UK NHS Gender Identity Clinic (GIC), where weight is topicalized during discussions about the risks of treatment. ⋯ Small differences in the wording of turns that initiate discussions about a possible weight problem can have significant consequences for interactional alignment. Clinicians from different specialities may benefit from considering the interactional consequences of different practices for initiating discussions about weight during the kinds of real-life discussions considered here. Statement of contribution What is already known on this subject? There is a correlation between clinical communication about weight and patient weight loss. Clinicians from all specialties are encouraged to discuss diet and exercise with patients, but communication about weight remains problematic. Health psychologists have identified an urgent need for communication training to raise sensitive topics like weight without damaging the doctor-patient relationship. What does this study add? Clinicians in a non-weight-specific setting use three communication practices to introduce the possibility that a patient's weight may be a problem. These practices have varying consequences for the interaction and doctor-patient relationship. Conversation analytic findings may be useful in training clinicians how to initiate discussions about weight with patients.