Why GP's do (not) counsel overweight and obese patients about their weight problems: testing the theory of trying. Belgium, April 2011

Abstract

Obesity can lead to several severe health problems and has become a serious social health problem. Since 1980, the prevalence of obesity worldwide has doubled and according to recent data 15.5% of adults are obese in Europe. General practitioners (GP's) are well placed to counsel overweight and obese patients about their weight. In general, patients tend to listen to them and take their advice seriously. However, GP's often do not initiate weight counseling with their overweight and obese patients and percentages of overweight or obese people receiving weight counseling are low and even dropping. In this study, we apply and test the Theory of Trying (ToT) model with respect to the intention of GP's to discuss weight problems with patients. The ToT, as an extension of the theory of planned behavior, is also a model of behavioral change and poses that intention is influenced by attitude, social norms, self-efficacy and past behavior. On its turn, attitude is influenced by attitude towards trying and succeeding, attitude towards trying and failing, and attitude towards the process. An online questionnaire was used to collect the data of 208 Belgian GP's (Flemish region). The measurement and structural model were tested with structural equation modeling (AMOS) and showed adequate model fit. Attitude was influenced by the attitude towards the process (p < .001). Intentions were significantly influenced by attitude (p=.02), self-efficacy (p < .001), past behavior (p =.01), and marginally significantly by social norms (p = .08). These results support the theory of trying model. Practical implications state that GP's need to feel confident in their skills for counseling about weight loss. By adequate training or lessons their self-efficacy can be heightened, leading them to counsel their patients about their weight more rapidly. Furthermore, since past behavior is of influence, GP's should start counseling about their weight early on in their career, leading them to maintain this behavior in the future. The third influential factor, attitude, is influenced by attitude towards the process. Thus, by positively changing the attitude GP's have about the process of weight counseling, GP's will have higher intentions to counsel their obese patients.