Table 3 Reported practice changes during group interviews

Development of an obesity management procedure

Recognition of obesity as a medical problem

“I was doing it less often before, I write obesity or overweight in my (medical) problem list.”

Measures of anthropometric data and history of weight

“I do it (waist circumference) now in almost all patients who come to my office”

“Like all our follow-up, we will weight them more, calculate the body mass index...”

Weight management is part of the usual intervention

“It’s a subject that I will approach more easily than before.”

“It also brought a focus on the treatment of obesity in the clinic which was not present before”

Realistic weight loss goals

“(I tell my patients) to aim for 5 to 10% of weight loss…”

“You will not be back to your healthy weight but if you lose 10% already it is meaningful for your health.”

Frequent appointments

“For most (patients with obesity), I see them every four weeks.”

Weight maintenance is a success in some patients

“This is an argument I did not have: you're not gaining (weight) but at least you are maintaining it.”

... they do more exercise than before and have better eating habit, they can be winners. They will certainly maintain their weight.

Increased physical activity counselling

“Walking, I talk about it all the time”

Use of food diary

“Using the food diary, it was something that was frightening me ….. but I tried it with some patients and I saw that we could carry on with that and it was beneficial.”

“I used the food diary a lot.”