Ambulatory management of childhood obesity.
OBJECTIVE
Childhood obesity is one of the most challenging issues facing healthcare providers today. The aims of this study were to describe the ambulatory management of childhood obesity by pediatricians (PDs) and family physicians (FPs) and to evaluate knowledge of and adherence to published recommendations.


METHODS
A 42-item, self-administered questionnaire was mailed to 1207 randomly selected primary care physicians (PDs = 700, FPs = 507) between September 2001 and January 2002.


RESULTS
Of 339 (28%) responses, 287 were eligible (PDs = 213, FPs = 74). Most respondents were in group or solo practice (87%) in a suburban or urban, non-inner city location (67%). The average age was 48 years (range = 31 to 85 years), and the mean years in practice was 17 (range = 1 to 55 years). Nineteen percent of physicians were aware of national recommendations. Three percent of physicians reported adherence to all recommendations. Knowledge of recommendations was not associated with a greater likelihood of adherence. However, physicians who were aware of recommendations were more likely to have positive attitudes about personal counseling ability (odds ratio = 2.4, confidence interval = 1.3 to 4.4) and the overall efficacy of obesity counseling (odds ratio = 4.3, confidence interval = 1.7 to 10.8). Poor patient motivation, patient noncompliance, and treatment futility were perceived as the most frequently encountered barriers to obesity treatment.


CONCLUSIONS
Most physicians are not aware of or adherent to national recommendations regarding childhood obesity. Awareness of recommendations was associated with more positive attitudes about personal counseling ability and the effectiveness of obesity counseling in general.
Kolagotla
Lakshmi
L
Division of General Pediatrics, Boston University School of Medicine/Boston Medical Center, Boston, Massachusetts 02118, USA. lakolago@bmc.org
Adams
William
W
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D015362:Child Nutrition Disorders / Q000517:prevention & control*; D002983:Clinical Competence; D003376:Counseling; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000517:prevention & control*; D010349:Patient Compliance; D010372:Pediatrics; D010821:Physicians, Family / Q000523:psychology*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires