Physicians' weight loss counseling in two public hospital primary care clinics.
OBJECTIVE
Primary care physicians are an important source of information on weight management. Nevertheless, weight loss counseling by these physicians remains inadequate. This study sought to determine physicians' barriers to providing weight loss counseling in a public hospital, patients' recall of physicians' weight loss recommendations, and the influence of physicians' counseling on patients' understanding, motivation, and behavior regarding weight loss.


METHODS
In 2001, four focus groups of faculty and residents were held at two primary care clinics affiliated with the Louisiana State University Health Sciences Center-Shreveport to determine the barriers to providing weight loss counseling. Scripted probes were used to uncover consensus norms. In 2001-02, structured exit interviews were conducted with 210 overweight or obese patients recruited from the clinics to determine patients' recall of physicians' weight loss recommendations, and patients' understanding of the relationship between weight and health, and their stages of readiness for weight loss.


RESULTS
Physicians identified major barriers to providing weight loss counseling, including insufficient confidence, knowledge, and skills. Obesity was underdocumented as a distinct clinical diagnosis. Only 5% of the patients recalled being given the combined weight loss strategy of diet and exercise. However, patients who recalled being counseled to lose weight were more likely to understand the risks of obesity, the benefits of weight loss, and were at a higher stage of readiness for weight loss.


CONCLUSIONS
Physicians' weight loss counseling had a significant effect on patients' understanding of and motivation for weight loss. However, physicians provided insufficient guidance on weight management strategies, possibly because of inadequate counseling skills and confidence.
Huang
Jian
J
Lusiana State University Health Sciences Center, Shreveport, Louisiana 71130-3932, USA. jhuang@lsuhsc.edu
Yu
Herbert
H
Marin
Estela
E
Brock
Stephanie
S
Carden
Donna
D
Davis
Terry
T
D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003376:Counseling; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000628:therapy; D005260:Female; D017144:Focus Groups; D006779:Hospitals, Public; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications / Q000628:therapy; D007407:Interviews as Topic; D016015:Logistic Models; D008145:Louisiana; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000628:therapy; D010044:Outpatient Clinics, Hospital; D010819:Physician's Role; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care; D012494:Sampling Studies; D015431:Weight Loss