General practitioners' and patients' models of obesity: whose problem is it?

Primary care literature emphasises the importance of agreement and shared m odels in the consultation. This study compared general practitioners' (GPs' ) and patients' models of obesity. Questionnaires concerning beliefs about the causes, consequences and solutions to obesity were completed by 89 gene ral practitioners (GPs) and 599 patients from practices across UK. In terms of causes, the results showed that the patients were more likely to attrib ute obesity to a gland/hormone problem, slow metabolism and stress than the GPs, whereas the GPs were more likely to blame eating too much. In terms o f consequences, the patients rated difficulty getting to work more highly w hereas the GPs regarded diabetes as more important. For the solutions to ob esity. the two groups reported similar beliefs for a range of methods, but whereas the patients rated the GP and a counsellor as more helpful. the GPs rated the obese person themselves more highly. It is argued that patients show a self serving model of obesity by blaming internal uncontrollable fac tors for causing obesity yet expecting external factors to solve it. In con trast, GPs show a victim blaming model by attributing both cause and the so lution to internal controllable factors. Such differing models have implica tions regarding the form of intervention likely to be used in primary care and indicate that whereas patients would prefer a more professional based a pproach. GPs would prefer a more patient-led one. Further. the results sugg est that even if an intervention could be negotiated, success rates would b e low as either the patient or the GP would be acting in contradiction to t heir beliefs about the nature of obesity. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.