PhD graduate's research explores communication challenges in obesity and pregnancy care
Discussions about obesity in pregnancy present unique challenges, shaped by medical perspectives, personal experiences, weight stigma and societal narratives.
When patients and clinicians approach these conversations from different standpoints, misunderstandings can arise, influencing both the quality of care and patient trust.
Rachel Dadouch’s PhD research, recently published in PLOS ONE, delves into these communication dynamics, identifying key areas where perspectives diverge and how these differences impact patient care.
Conducted during her PhD at the University of Toronto’s Institute of Medical Science, Dadouch’s thesis explores the intricacies of clinical encounters involving obesity in pregnancy and how these encounters influence care experiences and outcomes.
The study team and participants were recruited through Sinai Health.
Dadouch was co-supervised by Janet Parsons, associate professor in the Department of Occupational Science & Occupational Therapyat U of T, and Rohan D’Souza, now associate professor in the departments of Obstetrics & Gynecology and Health Research Methods, Evidence, and Impact at McMaster University.
Dadouch graduated from IMS in 2023 and now continues this work as a Postdoctoral Fellow at McMaster under D’Souza’s supervision.
Unpacking the Communication Divide
Dadouch’s research originated from the Core Outcome Set for Studies on Pregnant Patients (COSSOPP), where she observed a striking disconnect: clinicians and patients were speaking about obesity in vastly different ways, including their use of the term itself.
Clinicians frequently expressed uncertainty about how to approach weight-related discussions, while many patients reported feeling dismissed, uninformed, or stigmatized. These insights led her to investigate how communication breaks down in obesity-in-pregnancy clinical encounters and how this divide influences healthcare experiences.
Through in-depth interviews, Dadouch identified five central “narrative tensions” – fundamental points where perspectives diverge both between and within patient and clinician groups. An individual’s personal history with weight-related discussions shape their position, influencing how clinical conversations unfold and whether both patient and clinician leave the interaction feeling understood and supported.
“Many patients shared experiences that reflected long-standing weight stigma in medical settings, some dating back to childhood,” said Dadouch.
“These experiences shape their expectations and interactions with healthcare providers. My goal with this research is not to assign blame but to foster dialogue that bridges gaps in understanding and promotes more constructive conversations.”
Strengthening Patient-Clinician Dialogue
While Dadouch’s findings highlight the complexities of obesity-related discussions, they also serve as a foundation for developing more effective communication strategies. The next phase of her research will focus on identifying tangible approaches clinicians can use to facilitate more open, compassionate, and productive discussions about weight.
Dadouch also hopes her research will inform broader systemic change. “There is a growing sense of distrust in healthcare, and improving communication is one of the most immediate ways to rebuild that trust,” she notes.
“Listening to patients and validating their concerns is not just an ethical obligation – it is a critical step toward fostering a more inclusive and effective healthcare system.”
This article was adapted from the FLOURISH Lab's news story.
