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Am Fam Physician. 2024;109(4):372-373

Clinical Question

Is a framework that highlights the benefits of weight loss better than one that highlights the risks of excessive weight when suggesting weight loss to patients?

Bottom Line

Presenting weight loss as an opportunity is a better approach than scolding patients for their weight. Framing weight loss in terms of its positive effects, rather than listing the risks of excessive weight, increased weight loss and participation in a weight-loss program. (Level of Evidence = 2b)


The study evaluated conversations between clinicians and participants in a study of brief interventions to motivate patients to lose weight. The 246 recorded conversations were coded by three authors to determine the valence of the initial information from clinicians by categorizing it as good news, bad news, or information that was provided neutrally. When the clinician began the discussion by offering weight loss as an opportunity or by asserting the benefits of weight loss, especially in an enthusiastic manner, participants were more likely to agree to attend a weight-loss program, actually attend the program, and lose more weight (an average of 3.62 kg [7.98 lb]) than when the solicitation was delivered in neutral terms or by listing the harms of excessive weight.

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POEMs (patient-oriented evidence that matters) are provided by Essential Evidence Plus, a point-of-care clinical decision support system published by Wiley-Blackwell. For more information, see Copyright Wiley-Blackwell. Used with permission.

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This series is coordinated by Natasha J. Pyzocha, DO, contributing editor.

A collection of POEMs published in AFP is available at

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