title: Physicians' attitudes about obesity and their associations with competency and specialty: a cross-sectional study.
abstract: BACKGROUND
  Physicians frequently report negative attitudes about obesity which is thought to affect patient care. However, little is known about how attitudes toward treating obese patients are formed. We conducted a cross-sectional survey of physicians in order to better characterize their attitudes and explore the relationships among attitudes, perceived competency in obesity care, including report of weight loss in patients, and other key physician, training, and practice characteristics.
  
  
  METHODS
  We surveyed all 399 physicians from internal medicine, pediatrics, and psychiatry specialties at one institution regarding obesity care attitudes, competency, including physician report of percent of their patients who lose weight. We performed a factor analysis on the attitude items and used hierarchical regression analysis to explore the degree to which competency, reported weight loss, physician, training and practice characteristics explained the variance in each attitude factor.
  
  
  RESULTS
  The overall response rate was 63%. More than 40% of physicians had a negative reaction towards obese patients, 56% felt qualified to treat obesity, and 46% felt successful in this realm. The factor analysis revealed 4 factors-Physician Discomfort/Bias, Physician Success/Self Efficacy, Positive Outcome Expectancy, and Negative Outcome Expectancy. Competency and reported percent of patients who lose weight were most strongly associated with the Physician Success/Self Efficacy attitude factor. Greater skill in patient assessment was associated with less Physician Discomfort/Bias. Training characteristics were associated with outcome expectancies with newer physicians reporting more positive treatment expectancies. Pediatric faculty was more positive and psychiatry faculty less negative in their treatment expectancies than internal medicine faculty.
  
  
  CONCLUSIONS
  Physician attitudes towards obesity are associated with competency, specialty, and years since postgraduate training. Further study is necessary to determine the direction of influence and to explore the impact of these attitudes on patient care.
authors: Division of General Internal Medicine, New York University School of Medicine, New York, NY, USA. jaym01@med.nyu.edu
authors: Melanie
authors: M
authors: Jay
authors: Adina
authors: A
authors: Kalet
authors: Tavinder
authors: T
authors: Ark
authors: Michelle
authors: M
authors: McMacken
authors: Mary Jo
authors: MJ
authors: Messito
authors: Regina
authors: R
authors: Richter
authors: Sheira
authors: S
authors: Schlair
authors: Scott
authors: S
authors: Sherman
authors: Sondra
authors: S
authors: Zabar
authors: Colleen
authors: C
authors: Gillespie
mesh_terms: D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D006801:Humans; D007388:Internal Medicine; D009518:New York; D009765:Obesity / Q000523:psychology* / Q000628:therapy; D010372:Pediatrics; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology* / Q000706:statistics & numerical data; D011570:Psychiatry; D012044:Regression Analysis; D011795:Surveys and Questionnaires