title: U.S. primary care physicians' diet-, physical activity-, and weight-related care of adult patients.
abstract: BACKGROUND
  Overweight and obesity are substantial problems in the U.S., but few national studies exist on primary care physicians' (PCPs') clinical practices regarding overweight and obesity.
  
  
  OBJECTIVE
  To profile diet, physical activity, and weight control practice patterns of PCPs who treat adults.
  
  
  METHODS
  A nationally representative survey of 1211 PCPs sampled from the American Medical Association's Masterfile was conducted in 2008 and analyzed in 2010. Outcomes included PCPs' assessment, counseling, referral, and follow-up of diet, physical activity, and weight control in adult patients with and without chronic disease and PCPs' use of pharmacologic treatments and surgical referrals for overweight and obesity.
  
  
  RESULTS
  The survey response rate was 64.5%. Half of PCPs (49%) reported recording BMI regularly. Fewer than 50% reported always providing specific guidance on diet, physical activity, or weight control. Regardless of patients' chronic disease status, <10% of PCPs always referred patients for further evaluation/management and <22% reported always systematically tracking patients over time concerning weight or weight-related behaviors. Overall, PCPs were more likely to counsel on physical activity than on diet or weight control (p's<0.05). More than 70% of PCPs reported ever using pharmacologic treatments to treat overweight and 86% had referred for obesity-related surgery.
  
  
  CONCLUSIONS
  PCPs' assessment and behavioral management of overweight and obesity in adults is at a low level relative to the magnitude of the problem in the U.S. Further research is needed to understand barriers to providing care and to improve physician engagement in tracking and managing healthy lifestyles in U.S. adults.
authors.affiliation: Division of Cancer Control and Population Sciences National Cancer Institute, NIH, Bethesda, Maryland 20892-7344, USA. smithas@mail.nih.gov
authors.forename: Ashley Wilder
authors.initials: AW
authors.lastname: Smith
authors.forename: Laurel A
authors.initials: LA
authors.lastname: Borowski
authors.forename: Benmei
authors.initials: B
authors.lastname: Liu
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Galuska
authors.forename: Caroline
authors.initials: C
authors.lastname: Signore
authors.forename: Carrie
authors.initials: C
authors.lastname: Klabunde
authors.forename: Terry T-K
authors.initials: TT
authors.lastname: Huang
authors.forename: Susan M
authors.initials: SM
authors.lastname: Krebs-Smith
authors.forename: Erica
authors.initials: E
authors.lastname: Frank
authors.forename: Nico
authors.initials: N
authors.lastname: Pronk
authors.forename: Rachel
authors.initials: R
authors.lastname: Ballard-Barbash
mesh_terms: D000328:Adult; D001835:Body Weight; D004032:Diet; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009765:Obesity / Q000628:therapy*; D050177:Overweight / Q000628:therapy*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000379:methods*; D014481:United States