Table 4.
Theme | Representative Quotes | Interpretation |
---|---|---|
Barriers to intervention for provider participants | ||
Counseling as ineffective |
“I think the general approach is, how many battles am I choosing today?” On effective counseling methods: “My cynical side is tempted to say nothing. But I think maybe recognizing somebody who is actually motivated to change… I think what works best is internal motivation.” “The sample size of those patients who have tried to lose … is relatively small. I can probably count them on one hand.” |
• Fatalistic attitude towards obesity counseling • Ineffective counseling |
Patients not motivated to change |
“My perception is that they are not as concerned about their weight as I am.”
“I think a majority of patients are not motivated to lose weight.” “I think what they want is, can I identify a lab, can I identify some treatment…but you’re only going to lose weight if you eat less calories.” |
• Patients lack concern, motivation and hope for quick fixes or underlying causes for obesity |
Negative reactions to weight loss |
“I had one lady that lost 15 pounds and it seemed stress related. But she was still obese and concerned that she was too skinny.”
“I would inquire about whether or not they’ve been sick…to try and figure out whether or not there is something, if they have not been trying to intentionally lose weight.” |
• Regional preference for overweight body habitus • HIV infection prompts different response from providers |