Overweight patients in Primary Care: How Family Physicians Utilize Medical Check-up Examinations for Risk Counselling Content analysis of check-up counselling talks between physicians and patients

Background: The number of overweight patients in Germany has been continuously increasing during the past years. The so-called check-up 35 consultation presents primary care providers with an opportunity for preventive counselling talks with the respective individuals. In this qualitative study we analysed family physician encounters. We were particularly interested in the way in which the subject matter was addressed and the risk counselling performed by the physicians when confronted with overweight patients. Methods: Twelve physicians audio-taped their final check-up dialogue with 52 overweight or obese patients (BMI >= 25kg/m(2)). The interviews were transcribed, and a content analysis was conducted using the established method developed by Mayring. Results: Physicians used direct or more often indirect strategies to address overweight in counselling talks that were most often initiated by their patients. They largely addressed this topic while communicating laboratory results. Some obese patients did not receive any advice on health risks. In the encounters analysed the physicians did not employ standardized risk counselling tools. Conclusions: The reasons for addressing overweight indirectly and the lack of standardized risk counselling with obese patients are carefully discussed.