Women's perceptions of body mass graphics and their preferences for weight counselling

Health care providers may lack data-driven guidance about best practises for discussing weight. We assessed women's self-perception of body mass index (BMI) and preferences for weight counselling by provider characteristics and the initiating question. A voluntary, anonymous survey was completed by 756 women (age ≥ 19 year) at our tertiary care obstetrics and gynaecology clinics in autumn 2021. The respondents' height and weight were collected before respondents selected graphics from a validated Body Image Scale that they felt best represented their current body size and which graphs should prompt weight loss or gain recommendations. Respondents were asked their preferences about provider characteristics for discussion about weight and to identify which of six initiating questions from a provider was most and least preferred. Blank responses were allowed. In 708 responses, 366 women (52%) selected the most accurate graphic that corresponded to their BMI; the selected graphic represented a lower than actual BMI in 268 women (38%) and higher in 74 women (10%). In 648 responses, 374 women (58%) preferred a female provider, but provider body shape, ethnicity/race and age were not important to most women. The most preferred question to initiate a discussion about weight was “A lot of women have trouble achieving or maintaining a healthy weight; is that something we can discuss?” in 181 of 555 women (33%), and the least preferred question was “Do you feel like you are at an appropriate weight?” in 172 of 554 women (31%). Provider knowledge about patient preferences regarding questions may facilitate the discussion about weight.