Abstract

Background: Guidelines recommend that physicians screen all adults for obesity and offer an intensive counseling and behavioral interventions for weight loss for obese adults. Current trends of weight-related counseling are unknown in the setting of the US obesity epidemic. Objectives: To describe primary care physician (PCP) weight-related counseling, comparing counseling rates in 1995-1996 and 2007-2008. Research Design:: Data analysis of outpatient PCP visits in 1995-1996 and 2007-2008, as reported in the National Ambulatory Medical Care Survey. Subjects: A total of 32,519 adult primary care visits with PCPs. Measures: Rates of counseling for weight, diet, exercise, and a composite variable, weight-related counseling (defined as counseling for weight, diet, or exercise) between survey years. Adjusted analyses controlled for patient and visit characteristics. Results: Weight counseling declined from 7.8% of visits in 1995-1996 to 6.2% of visits in 2007-2008 [adjusted odds ratios, 0.64; 95% confidence intervals, 0.53, 0.79]. Rates of receipt of diet, exercise, and weight-related counseling similarly declined. Greater declines in odds of weight-counseling receipt were observed among those with hypertension (47%), diabetes (59%), and obesity (41%), patients who stand the most to gain from losing weight. Conclusions: Rates of weight counseling in primary care have significantly declined despite increased rates of overweight and obesity in the United States. Further, these declines are even more marked in patients with obesity and weight-related comorbidities, despite expectations to provide such care by both patients and policymakers. These findings have implications for determining deliverable, novel ways to engage PCPs in addressing the obesity epidemic.

Original languageEnglish (US)
Pages (from-to)186-192
Number of pages7
JournalMedical care
Volume51
Issue number2
DOIs
StatePublished - Feb 1 2013

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Counseling
Obesity
Physicians
Weights and Measures
Primary Care Physicians
Exercise
Diet
Primary Health Care
Health Care Surveys
Ambulatory Care
Weight Gain
Comorbidity
Weight Loss
Patient Care
Research Design
Odds Ratio
Guidelines
Confidence Intervals
Hypertension

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health

Cite this

@article{0e13f809b87043f7a5ca57edc30cce05,
title = "A silent response to the obesity epidemic: Decline in US physician weight counseling",
abstract = "Background: Guidelines recommend that physicians screen all adults for obesity and offer an intensive counseling and behavioral interventions for weight loss for obese adults. Current trends of weight-related counseling are unknown in the setting of the US obesity epidemic. Objectives: To describe primary care physician (PCP) weight-related counseling, comparing counseling rates in 1995-1996 and 2007-2008. Research Design:: Data analysis of outpatient PCP visits in 1995-1996 and 2007-2008, as reported in the National Ambulatory Medical Care Survey. Subjects: A total of 32,519 adult primary care visits with PCPs. Measures: Rates of counseling for weight, diet, exercise, and a composite variable, weight-related counseling (defined as counseling for weight, diet, or exercise) between survey years. Adjusted analyses controlled for patient and visit characteristics. Results: Weight counseling declined from 7.8{\%} of visits in 1995-1996 to 6.2{\%} of visits in 2007-2008 [adjusted odds ratios, 0.64; 95{\%} confidence intervals, 0.53, 0.79]. Rates of receipt of diet, exercise, and weight-related counseling similarly declined. Greater declines in odds of weight-counseling receipt were observed among those with hypertension (47{\%}), diabetes (59{\%}), and obesity (41{\%}), patients who stand the most to gain from losing weight. Conclusions: Rates of weight counseling in primary care have significantly declined despite increased rates of overweight and obesity in the United States. Further, these declines are even more marked in patients with obesity and weight-related comorbidities, despite expectations to provide such care by both patients and policymakers. These findings have implications for determining deliverable, novel ways to engage PCPs in addressing the obesity epidemic.",
author = "Kraschnewski, {Jennifer L.} and Sciamanna, {Christopher N.} and Stuckey, {Heather L.} and Chuang, {Cynthia H.} and Lehman, {Erik B.} and Hwang, {Kevin O.} and Sherwood, {Lisa L.} and Nembhard, {Harriet B.}",
year = "2013",
month = "2",
day = "1",
doi = "10.1097/MLR.0b013e3182726c33",
language = "English (US)",
volume = "51",
pages = "186--192",
journal = "Medical Care",
issn = "0025-7079",
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A silent response to the obesity epidemic : Decline in US physician weight counseling. / Kraschnewski, Jennifer L.; Sciamanna, Christopher N.; Stuckey, Heather L.; Chuang, Cynthia H.; Lehman, Erik B.; Hwang, Kevin O.; Sherwood, Lisa L.; Nembhard, Harriet B.

In: Medical care, Vol. 51, No. 2, 01.02.2013, p. 186-192.

Research output: Contribution to journalArticle

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T1 - A silent response to the obesity epidemic

T2 - Decline in US physician weight counseling

AU - Kraschnewski, Jennifer L.

AU - Sciamanna, Christopher N.

AU - Stuckey, Heather L.

AU - Chuang, Cynthia H.

AU - Lehman, Erik B.

AU - Hwang, Kevin O.

AU - Sherwood, Lisa L.

AU - Nembhard, Harriet B.

PY - 2013/2/1

Y1 - 2013/2/1

N2 - Background: Guidelines recommend that physicians screen all adults for obesity and offer an intensive counseling and behavioral interventions for weight loss for obese adults. Current trends of weight-related counseling are unknown in the setting of the US obesity epidemic. Objectives: To describe primary care physician (PCP) weight-related counseling, comparing counseling rates in 1995-1996 and 2007-2008. Research Design:: Data analysis of outpatient PCP visits in 1995-1996 and 2007-2008, as reported in the National Ambulatory Medical Care Survey. Subjects: A total of 32,519 adult primary care visits with PCPs. Measures: Rates of counseling for weight, diet, exercise, and a composite variable, weight-related counseling (defined as counseling for weight, diet, or exercise) between survey years. Adjusted analyses controlled for patient and visit characteristics. Results: Weight counseling declined from 7.8% of visits in 1995-1996 to 6.2% of visits in 2007-2008 [adjusted odds ratios, 0.64; 95% confidence intervals, 0.53, 0.79]. Rates of receipt of diet, exercise, and weight-related counseling similarly declined. Greater declines in odds of weight-counseling receipt were observed among those with hypertension (47%), diabetes (59%), and obesity (41%), patients who stand the most to gain from losing weight. Conclusions: Rates of weight counseling in primary care have significantly declined despite increased rates of overweight and obesity in the United States. Further, these declines are even more marked in patients with obesity and weight-related comorbidities, despite expectations to provide such care by both patients and policymakers. These findings have implications for determining deliverable, novel ways to engage PCPs in addressing the obesity epidemic.

AB - Background: Guidelines recommend that physicians screen all adults for obesity and offer an intensive counseling and behavioral interventions for weight loss for obese adults. Current trends of weight-related counseling are unknown in the setting of the US obesity epidemic. Objectives: To describe primary care physician (PCP) weight-related counseling, comparing counseling rates in 1995-1996 and 2007-2008. Research Design:: Data analysis of outpatient PCP visits in 1995-1996 and 2007-2008, as reported in the National Ambulatory Medical Care Survey. Subjects: A total of 32,519 adult primary care visits with PCPs. Measures: Rates of counseling for weight, diet, exercise, and a composite variable, weight-related counseling (defined as counseling for weight, diet, or exercise) between survey years. Adjusted analyses controlled for patient and visit characteristics. Results: Weight counseling declined from 7.8% of visits in 1995-1996 to 6.2% of visits in 2007-2008 [adjusted odds ratios, 0.64; 95% confidence intervals, 0.53, 0.79]. Rates of receipt of diet, exercise, and weight-related counseling similarly declined. Greater declines in odds of weight-counseling receipt were observed among those with hypertension (47%), diabetes (59%), and obesity (41%), patients who stand the most to gain from losing weight. Conclusions: Rates of weight counseling in primary care have significantly declined despite increased rates of overweight and obesity in the United States. Further, these declines are even more marked in patients with obesity and weight-related comorbidities, despite expectations to provide such care by both patients and policymakers. These findings have implications for determining deliverable, novel ways to engage PCPs in addressing the obesity epidemic.

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