Suboptimal identification of obesity by family physicians.
OBJECTIVE
To examine how family physicians identify and document obesity.


METHODS
Prospective cross-sectional study of 289 patients in 7 family practice clinics of Clalit Health Services in Israel.


METHODS
Two hundred eighty-nine patients from 7 family practice clinics had their body mass index (BMI [calculated as weight in kilograms divided by height in meters squared]) determined by the study staff and subsequently compared with the data retrieved from the family practices' database regarding physicians' BMI documentation and obesity diagnosis. Demographic variables, comorbidities, and medication use were also extracted. Multivariate odds ratios (ORs) and 95% confidence intervals (CIs) were obtained to determine the predictors of BMI documentation.


RESULTS
Seventy-eight of 289 patients (27.0%) were obese (BMI, > or =30.0), and 126 (43.6%) were overweight (BMI range, 25.0 to < or =29.9). Body mass index was documented in 39 of 78 obese patients (50.0%) and in 49 of 126 overweight patients (38.9%) (P <.001). Diagnosis of obesity was recorded in 19 of 78 obese patients (24.4%). Older patients (OR, 2.77; 95% CI, 1.39-5.49) and obese patients (OR, 2.04; 95% CI, 1.04-3.99) were more likely to have their weight and height measured and BMI calculated by their physician. Patients with comorbid conditions such as diabetes mellitus (OR, 4.35; 95% CI, 2.20-8.62) and hypertension (OR, 3.20; 95% CI, 1.71-5.99) and patients taking chronic medications (OR, 3.44; 95% CI, 1.20-9.83) were also more likely to have their BMI documented.


CONCLUSIONS
Family physicians failed to identify most obese and overweight patients, as seen by lack of BMI documentation and concordant diagnoses in the medical problem list. Determination of BMI by physicians in family practice is of utmost importance, and its incorporation into medical care should be optimized.
Melamed
Osnat C
OC
Department of Family Medicine, Maccabi Healthcare Services, Tel Aviv University, 27 Ha'mered St, Tel Aviv 68125, Israel. osnatt@gmail.com
Nakar
Sasson
S
Vinker
Shlomo
S
D015992:Body Mass Index; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000175:diagnosis*; D016017:Odds Ratio; D050177:Overweight; D010821:Physicians, Family / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011787:Quality of Health Care / Q000592:standards*