Physical Therapists' Ways of Talking About Overweight and Obesity: Clinical Implications

Jenny Setchell, Bernadette M Watson, Micheal Gard, Liz Jones

How people think and talk about weight is important because it can influence their behavior towards people who are overweight. One study has shown that physical therapists have negative attitudes towards people who are overweight. However, how this translates into clinical practice is not well understood. Investigating physical therapists' ways of thinking and speaking about overweight and obesity in the context of their work can provide insight into this under-researched area. To investigate physical therapists' ways of talking about overweight individuals, and discuss clinical implications. The study employed an interpretive qualitative design. The research team used discourse analysis, a type of inductive qualitative methodology, to guide data collection and analysis. The data came from six focus groups of 4-6 physical therapists in Queensland, Australia who discussed weight in a physical therapy environment. Participants (n=27) represented a variety of physical therapy sub-disciplines. Data analysis identified four main weight discourses (ways of thinking/speaking about weight). Participants described patients who are overweight as 1) little affected by stigma, and 2) difficult to treat. Further, participants portrayed weight as 3) having simple causes, and 4) important in physical therapy. Alternate weight discourses were less frequent in these data. Results indicated some physical therapists' understandings of weight might lead to negative interactions with patients who are overweight. Findings suggest physical therapists require more nuanced understandings of: how patients who are overweight might feel in a physical therapy setting; the complexity of causes of weight; and possible benefits and disadvantages of introducing weight management discussions with patients. Therefore, education should encourage complex understandings of working with patients of all sizes including knowledge of weight stigma.