National patterns of physician activities related to obesity management.
BACKGROUND
National physician practices related to the clinical recognition and management of obesity are unknown.


OBJECTIVE
To estimate national patterns of office-based, obesity-related practices and to determine the independent predictors of these practices.


METHODS
Serial cross-sectional surveys of physician office visits.


METHODS
Ambulatory medical care in the United States.


METHODS
We analyzed 55,858 adult physician office visits sampled in the 1995-1996 National Ambulatory Medical Care Surveys. Data from the Third National Health and Nutrition Examination Surveys, 1988-1994 were used to assess and, then, adjust for the underreporting of obesity.


METHODS
Reporting of obesity at office visits and physician counseling for weight loss, exercise, and diet among patients identified as obese.


RESULTS
Physicians reported obesity in only 8.6% of 1995-1996 National Ambulatory Medical Care Surveys visits. The 22.7% prevalence rate of the Third National Health and Nutrition Examination Surveys, 1988-1994 suggests that physicians reported obesity in only 38% of their obese patients. Among visits by patients identified as obese, physicians frequently provided counseling for weight loss (35.5%), exercise (32.8%), and diet (41.5%). Adjusted for population prevalence; however, each service was provided to no more than one quarter of all obese patients. While patients with obesity-related comorbidities were treated more aggressively, in these patients, weight loss counseling occurred at only 52% of the visits.


CONCLUSIONS
Specific interventions to address obesity are infrequent in visits to US physicians. Obesity is underreported and interventions are only moderately likely among patients identified as obese, even for those with serious obesity-related comorbidities.
Institute for Health Policy, Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA. rstafford@partners.org
R S
RS
Stafford
J H
JH
Farhat
B
B
Misra
D A
DA
Schoenfeld
D000328:Adult; D000368:Aged; D003376:Counseling; D003430:Cross-Sectional Studies; D003625:Data Collection; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D010818:Practice Patterns, Physicians'; D012307:Risk Factors; D014481:United States