title: Effect of didactic lectures on obesity documentation and counseling among internal medicine residents.
abstract: BACKGROUND
  Screening adult patients for obesity and offering appropriate counseling and treatment for weight loss is recommended. However, many healthcare providers feel ill-equipped to address this topic.
  
  
  OBJECTIVE
  We examined whether didactic presentations lead to increased obesity documentation and counseling among internal medicine (IM) residents.
  
  
  METHODS
  We reviewed medical records of patients seen at the IM Resident Continuity Clinic during April 2015. Residents were provided feedback at two didactic presentations during May 2015. To examine the effect of this intervention, we repeated medical record review during June 2015. For both reviews, we abstracted patient-specific (i.e., age, body mass index [BMI], race, sex, and number of comorbid diagnoses) and resident-specific (i.e., sex and training level) data as well as evidence of obesity documentation and counseling. We used logistic regression models to examine the effect of intervention on obesity documentation and counseling, adjusting for patient- and resident-specific variables.
  
  
  RESULTS
  Of the 278 patients with BMI≥30 kg/m(2), 139 were seen before and 139 after the intervention. Intervention had no effect on obesity documentation or counseling with or without adjustment for confounding variables (both P>0.05). In adjusted post-hoc analyses, each additional comorbidity increased the odds of obesity documentation by 8% (OR=1.08; 95% CI=1.05-1.11; P<0.001). In addition, as compared to postgraduate year (PGY) 1 residents, PGY-3 residents were 56% (OR=0.44; 95% CI=0.21-0.95; P=0.03) less likely to counsel obese patients.
  
  
  CONCLUSIONS
  Obesity is inadequately addressed in primary care settings, and didactic presentations were unable to increase obesity documentation or weight loss counseling. Future research to identify effective interventions is needed.
authors.affiliation: Department of Internal Medicine, University of Tennessee College of Medicine Chattanooga, Chattanooga, TN, USA.
authors.forename: Vicky
authors.initials: V
authors.lastname: Ren
authors.affiliation: Department of Internal Medicine, University of Tennessee College of Medicine Chattanooga, Chattanooga, TN, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Ellison
authors.affiliation: Department of Internal Medicine, University of Tennessee College of Medicine Chattanooga, Chattanooga, TN, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Miller
authors.affiliation: Department of Internal Medicine, University of Tennessee College of Medicine Chattanooga, Chattanooga, TN, USA.
authors.forename: Kiran
authors.initials: K
authors.lastname: Busireddy
authors.affiliation: Department of Dermatology, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Erin
authors.initials: E
authors.lastname: Vickery
authors.affiliation: Department of Internal Medicine, University of Tennessee College of Medicine Chattanooga, Chattanooga, TN, USA; mukta.panda@erlanger.org.
authors.forename: Mukta
authors.initials: M
authors.lastname: Panda
authors.affiliation: Department of Internal Medicine, University of Tennessee College of Medicine Chattanooga, Chattanooga, TN, USA.
authors.forename: Rehan
authors.initials: R
authors.lastname: Qayyum
keywords: BMI; behavior modification; intervention; primary care; weight