title: The impact of obesity on primary care visits.
abstract: OBJECTIVE
  To investigate the influence of patient obesity on primary care physician practice style.
  
  
  METHODS
  This was a randomized, prospective study of 509 patients assigned for care by 105 primary care resident physicians. Patient data collected included sociodemographic information, self-reported health status (Medical Outcomes Study Short Form-36), evaluation for depression (Beck Depression Index), and satisfaction. Height and weight were measured to calculate the BMI. Videotapes of the visits were analyzed using the Davis Observation Code (DOC).
  
  
  RESULTS
  Regression equations were estimated relating obesity to visit length, each of the 20 individual DOC codes, and the six DOC Physician Practice Behavior Clusters, controlling for patient health status and sociodemographics. Obesity was not significantly associated with the length of the visit, but influenced what happened during the visit. Physicians spent less time educating obese patients about their health (p = 0.0062) and more time discussing exercise (p = 0.0075). Obesity was not related to discussions regarding nutrition. Physicians spent a greater portion of the visit on technical tasks when the patient was obese (p = 0.0528). Mean pre-visit general satisfaction for obese patients was significantly lower than for non-obese patients (p = 0.0069); however, there was no difference in post-visit patient satisfaction.
  
  
  CONCLUSIONS
  Patient obesity impacts the medical visit. Further research can promote a greater understanding of the relationships between obese patients and their physicians.
authors.affiliation: Department of Family and Community Medicine, University of California, Davis, Sacramento, CA 95817, USA. kdbertakis@ucdavis.edu
authors.forename: Klea D
authors.initials: KD
authors.lastname: Bertakis
authors.forename: Rahman
authors.initials: R
authors.lastname: Azari
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000523:psychology*; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011320:Primary Health Care / Q000379:methods; D011446:Prospective Studies; D012044:Regression Analysis; D011795:Surveys and Questionnaires