Doctors and patients' perspectives on obesity. A Q-methodology study

Fam Pract. 2022 Jul 19;39(4):694-700. doi: 10.1093/fampra/cmab169.

Abstract

Background: Obesity is associated with stigma and discrimination. Health care providers should approach these patients professionally and without stigma, since treatment of obesity requires a relationship with mutual understanding between the doctor and patient.

Objective: To explore how patients and general practitioners (GPs) perceive obesity, using Q-methodology, which allows quantitative analysis of qualitative data.

Methods: A Q-methodology study, comprising 24 patients with obesity and 24 GPs. We created 48 statements with viewpoints on obesity. All participants sorted these statements in a forced grid with a quasi-normal distribution ranking from -5 (most disagree) to +5 (most agree). Subsequently, factor analysis was performed. Six patients were interviewed to explain their viewpoints.

Results: Analysis yielded 3 dominant groups (factors) of patients: (i) They acknowledge the importance of healthy lifestyle and feel mistreated by health care. (ii) They have a decreased quality of life, but do not blame health care, and (iii) They don't need treatment and don't have an impaired quality of life. For the GPs, the 3 dominant factors were: (i) They have understanding for the patients and feel that health care is insufficient, (ii) They believe that obesity may be hereditary but mainly is a lifestyle problem, and (iii) They believe obesity can be treated but is very difficult.

Conclusions: Viewpoints on obesity were different, both within and between the groups. Some GPs consider obesity mainly as a lifestyle problem, rather than a chronic disease. If patients and doctors can find mutual viewpoints on obesity, both patient satisfaction and a treatment strategy will be more effective.

Keywords: factor analysis (statistical); health communication; obesity; patient satisfaction; primary health care; qualitative research.

Plain language summary

Obesity affects quality of life and increases the risk of diseases such as type 2 diabetes, fatty liver disease, cardiovascular disease, and cancer. Achieving and maintaining weight loss is difficult and for this reason a mutual understanding between the general practitioner (GP) and the patient is crucial. We used Q-methodology to study the patients and GPs perspectives on obesity. We show that there are different groups of patients that have different perspectives on obesity, but also different groups of doctors who have different perspectives on obesity. If the GP is aware of the fact that the patients’ viewpoints regarding obesity may be different than his/her own viewpoints, it allows improvement of the doctor–patient communication and hence, patient satisfaction.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Attitude of Health Personnel
  • Factor Analysis, Statistical
  • General Practitioners*
  • Humans
  • Obesity / therapy
  • Patient Satisfaction
  • Qualitative Research
  • Quality of Life*