title: Concordance of patient-physician obesity diagnosis and treatment beliefs in rural practice settings.
abstract: BACKGROUND
  Although clinical guidelines recommend routine screening and treatment for obesity in primary care, lack of agreement between physicians and patients about the need for obesity treatment in the primary care setting may be an unexplored factor contributing to the obesity epidemic.
  
  
  OBJECTIVE
  To better understand this dynamic, we surveyed 439 obese patients (body mass index >or=30) at the time of clinic visits in 2003 at diverse primary care settings in rural Kansas and conducted same-day interviews with their physicians (N = 28). We used Spearman's correlation to describe and compare patient and physician responses.
  
  
  RESULTS
  Most patients were women (66%). Their mean age was 55.8 years, and mean body mass index was 37.7. Half (51%) reported discussing their weight on that visit date. Overall, 51% of patients wanted to discuss weight more often with their physician and 54% wanted to discuss weight sooner. Patients and physicians gave similar assessments of the patient's preference for discussing weight loss, how often weight was discussed at visits, and the patient's motivation for weight loss. Spearman's correlations on these variables were .33, .54, and .25, respectively (all P < .001).
  
  
  CONCLUSIONS
  These patients and their physicians demonstrated a weak to moderate agreement on several variables crucial to initiating and continuing obesity care. Understanding patient and provider beliefs and preferences regarding obesity diagnosis and treatment is essential in designing obesity interventions for primary care.
authors.affiliation: Division of General and Geriatric Medicine, Department of Internal Medicine, University of Kansas Medical Center, Kansas City 66160, USA. aely@kumc.edu
authors.forename: Andrea Charbonneau
authors.initials: AC
authors.lastname: Ely
authors.forename: K Allen
authors.initials: KA
authors.lastname: Greiner
authors.forename: Wendi
authors.initials: W
authors.lastname: Born
authors.forename: Sandra
authors.initials: S
authors.lastname: Hall
authors.forename: Paula C
authors.initials: PC
authors.lastname: Rhode
authors.forename: Aimee S
authors.initials: AS
authors.lastname: James
authors.forename: Nicole
authors.initials: N
authors.lastname: Nollen
authors.forename: Jasjit S
authors.initials: JS
authors.lastname: Ahluwalia
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis* / Q000628:therapy*; D010817:Physician-Patient Relations; D019035:Rural Health Services