Diagnosis of obesity by primary care physicians and impact on obesity management.
OBJECTIVE
To evaluate whether primary care physicians document obesity as a diagnosis and formulate a management plan.


METHODS
The Mayo Clinic primary care database was used to identify general medical examinations performed from November 1, 2004, to October 31, 2005, in a primary care clinic for obese patients (body mass index [BMI] equals 30). Data on demographic variables, BMI, comorbidities, documentation of obesity, and obesity management strategy were obtained through the database. Multivariate logistic regression analyses were conducted to estimate multivariate odds ratios (ORs) and 95 percent confidence intervals (CIs).


RESULTS
A total of 9827 patients were seen for a general medical examination. Of the 2543 obese patients, 505 (19.9 percent) had a diagnosis of obesity documented, and 574 (22.6 percent) had an obesity management plan documented. Older patients (OR, 0.97 per year; 95 percent CI, 0.96-0.98) and men (OR, 0.60; 95% CI, 0.47-0.76) were significantly less likely to be diagnosed as having obesity, whereas those with a BMI greater than 35 (OR, 2.54; 95 percent CI, 2.10-3.16), diabetes mellitus (OR, 1.40; 95 percent CI, 1.09-1.78), and obstructive sleep apnea (OR, 2.34; 95 percent CI, 1.79 to 3.07) were significantly more likely to have the diagnosis made. Staff physicians were less likely than residents to document obesity as a diagnosis (OR, 0.55; 95 percent CI, 0.44 to 0.69). Diagnosis of obesity was the strongest predictor of formulation of an obesity plan (OR, 2.39; 95 percent CI, 1.90 to 3.02).


CONCLUSIONS
Most obese patients did not have a diagnosis of obesity or an obesity management plan made by their primary care physician. Diagnosis of obesity results in a higher chance of formulation of an obesity plan.
Bardia
Aditya
A
Division of Preventive, Occupational and Aerospace Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Holtan
Shernan G
SG
Slezak
Jeffrey M
JM
Thompson
Warren G
WG
D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D048909:Diabetes Complications; D005260:Female; D005544:Forecasting; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008499:Medical Records; D008505:Medical Staff, Hospital; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis* / Q000628:therapy; D010347:Patient Care Planning; D010808:Physical Examination; D010821:Physicians, Family; D011320:Primary Health Care; D012737:Sex Factors; D012891:Sleep Apnea Syndromes / Q000150:complications