Patient Education and Counseling
Volume 82, Issue 1 , Pages 123-129, January 2011

Physician practice patterns of obesity diagnosis and weight-related counseling

  • Sara N. Bleich

      Affiliations

    • Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, USA
    • Corresponding Author InformationCorresponding author at: Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, 624 N. Broadway, Room 451, Baltimore, MD 21205, United States. Tel.: +1 410 502 6604; fax: +1 410 614 9152.
    • ,
  • Octavia Pickett-Blakely

      Affiliations

    • Department of Medicine, Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, USA
    • ,
  • Lisa A. Cooper

      Affiliations

    • Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, USA
    • Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, USA

Received 17 November 2009; received in revised form 13 January 2010; accepted 13 February 2010. published online 22 March 2010.

Abstract 

Methods

We analyzed cross-sectional clinical encounter data. Obese adults were obtained from the 2005 National Ambulatory Medical Care Survey (N=2458).

Results

A third of obese adults received an obesity diagnosis (28.9%) and approximately a fifth received counseling for weight reduction (17.6%), diet (25.2%), or exercise (20.5%). Women (OR=1.54; 95% CI: 1.14, 2.09), young adults ages 18–29 (OR=2.61; 95% CI: 1.37, 4.97), and severely/morbidly obese individuals (class II: OR 2.08; 95% CI: 1.53, 2.83; class III: OR 4.36; 95% CI: 3.09, 6.16) were significantly more likely to receive an obesity diagnosis. One of the biggest predictors of weight-related counseling was an obesity diagnosis (weight reduction: OR=5.72; 95% CI: 4.01, 8.17; diet: OR=2.89; 95% CI: 2.05, 4.06; exercise: OR=2.54; 95% CI: 1.67, 3.85). Other predictors of weight-related counseling included seeing a cardiologist/other internal medicine specialist, a preventive visit, or spending more time with the doctor (p<0.05).

Conclusions

Most obese patients do not receive an obesity diagnosis or weight-related counseling.

Practice implications

Preventive visits may provide a key opportunity for obese patients to receive weight-related counseling from their physician.

Keywords: Obesity, Physician practice patterns, Weight-related counseling, Diagnosis

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PII: S0738-3991(10)00052-2

doi:10.1016/j.pec.2010.02.018

Patient Education and Counseling
Volume 82, Issue 1 , Pages 123-129, January 2011

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