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The Effect of Parental Presence on Weight-Related Discussions Between Physicians and Their Overweight Adolescent Patients

Primary care physicians (PCPs) can influence patient behavior change. Among overweight and obese adolescents, changes in diet and exercise may prevent obesity into adulthood and lead to healthier and more functional lives. However, little is known about how physicians attempt to promote weight-related change with their overweight adolescent patients. Guidelines recommend that physicians address more than 20 topics during routine visits, including sensitive topics such as sex and drugs.1 To promote honest disclosure, many physicians prefer to discuss these sensitive topics without the parent in the room. 
 
Questions persist concerning “triadic communication” among adolescents, their parents, and physicians. Obese children frequently have obese parents, and parental presence may affect the quality of communication.2 Physicians may find themselves needing to educate both child and parent, and parents may feel responsible for the adolescent. Thus, conversations are likely to differ depending on whether the parent is present or absent. 
 
In this article, we assess whether parental presence during the PCP–adolescent visit enhances or inhibits weight-related discussions. In the current analyses, we take advantage of audio-recorded encounters from Teen CHAT (Communicating Health: Analyzing Talk), a study aiming to reduce obesity through improved physician– adolescent communication.3