Primary care physicians and obesity mamagement: what did you expect?

U.S. Primary Care Physicians’ Diet-, Physical

Activity–, and Weight-Related Care of

Adult Patients

Ashley Wilder Smith, PhD, MPH, Laurel A. Borowski, MPH, Benmei Liu, PhD,

Deborah A. Galuska, PhD, Caroline Signore, MD, MPH, Carrie Klabunde, PhD,

Terry T-K Huang, PhD, MPH, Susan M. Krebs-Smith, PhD, Erica Frank, MD, MPH,

Nico Pronk, PhD, Rachel Ballard-Barbash, MD, MPH

Background: Overweight and obesity are substantial problems in the U.S., but few national studies

exist on primary care physicians’ (PCPs’) clinical practices regarding overweight and obesity.

Purpose: Toprofıle diet, physical activity, and weight control practice patterns of PCPswhotreat adults.

Methods: A nationally representative survey of 1211 PCPs sampled from the American Medical

Association’s Masterfıle was conducted in 2008 and analyzed in 2010. Outcomes included PCPs’

assessment, counseling, referral, and follow-up of diet, physical activity, and weight control in adult

patients with and without chronic disease and PCPs’ use of pharmacologic treatments and surgical

referrals for overweight and obesity.

Results: The survey response rate was 64.5%. Half of PCPs (49%) reported recording BMI regularly.

Fewer than 50% reported always providing specifıc guidance on diet, physical activity, or weight control.

Regardless of patients’ chronic disease status,10% of PCPs always referred patients for further evaluation/

management and 22% reported always systematically tracking patients over time concerning

weight or weight-related behaviors. Overall, PCPs were more likely to counsel on physical activity than on

diet or weight control (p’s0.05). More than 70% of PCPs reported ever using pharmacologic treatments

to treat overweight and 86% had referred for obesity-related surgery.

Conclusions: PCPs’ assessment and behavioral management of overweight and obesity in adults is

at a low level relative to the magnitude of the problem in the U.S. Further research is needed to

understand barriers to providing care and to improve physician engagement in tracking and managing

healthy lifestyles in U.S. adults.

(Am J Prev Med 2011;41(1):33– 42) © 2011 Published by Elsevier Inc. on behalf of American Journal of

Preventive Medicine.