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Weight loss advice given by general practitioners (GPs) to patients with obesity appeared to be lacking, one U.K.-based qualitative study suggested.

In an analysis of 159 audio recordings of patient consultations from the Brief Interventions for Weight Loss trial, the most common advice was diet and exercise, typically following an "eat less and do more" narrative, noted Madeleine Tremblett, PhD, of the University of Oxford in England, and colleagues.

Furthermore, only 33 of the 159 consultations included any guidance on how patients can actually implement this advice, "meaning advice was mostly given without any detail on how to follow it," the group wrote in .

Examples of broad-strokes dietary advice -- given in 44 of the 159 consultations -- included one physician advising several patients to simply "look at their diet," while another said "be careful what you eat and follow proper dietary advice."

In 26 of these consultations, physicians provided some guidance on changing the type and amount of food eaten, though, again, details were sparse. One physician said "I think, yeah, just try and reduce your carbohydrates next," while another explained to their patient to reach for a banana instead of a Mars bar.

There were very few instances in which doctors suggested monitoring of calorie intake, which occurred only during three consultations. Similarly, only nine consultations included recommendations of sticking to a specific type of diet, like a low-fat or intermittent fasting diet.

Recommendations for engaging in more physical activity were fairly uncommon, only occurring in 18 of the consultations, and even fewer included specific guidance on frequency or intensity of physical activity.

"Most advice was 'superficial' comprising unilaterally delivered content which was not personalized to patients, unless prompted by the patients in their response to general advice," Tremblett and colleagues noted.

"We found that when GPs were more specific than 'do more, eat less,' the advice given was highly varied, superficial, and often lacked an apparent evidence base for patients living with obesity," they explained. "Advice was mostly given in abstract (155/159 consultations), without providing any justification, or evidence for why the actions being recommended might support weight loss."

A total of 58 of the consultations included superficial advice, with one GP suggesting the patient simply "change their lifestyle a bit." Only 30 consultations offered personalized advice, such as when one GP suggested their patient make their own bread using gluten-free flour.

While advice on diet and exercise was a mixed bag, most GPs appeared to be on the same page when recommending additional support for their patients. This occurred in 78 of the consultations, which typically took the form of suggesting a follow-up appointment or offering a booklet from a medical organization.

"Our analysis identifies that clinicians mostly do not provide effective advice, and so even if patients were to follow the advice, they would be unlikely to lose weight," Tremblett's group wrote, pointing out that the "eat less, do more" approach was the common fallback advice when other resources weren't available. They also noted that patients didn't take well to this messaging and it's not likely to prove effective.

"Future training and guidelines can address misconceptions that this approach is effective for the population of people living with obesity," they suggested, "and instead emphasize the importance of offering support through referrals to weight management services if possible."

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