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05-10-2011 | Psychology | Article

Physicians not helping to address obesity epidemic


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MedWire News: US physicians may not be doing all they can to address the obesity epidemic, show study results that highlight a lack of lifestyle counseling in primary care.

The authors of the research believe the finding is consistent with the "low levels of perceived efficacy" that physicians have for such counseling programs.

"I think some of the problem is that we don't really know what works in primary care," explained co-investigator Chris Sciamanna (Penn State College of Medicine, Hershey) at the Obesity Society's 29th Annual Scientific Meeting in Orlando, Florida, USA.

Indeed, while the percentage of primary care visits that included weight counseling fell during the study period, those related to tobacco counseling did not, indicating a possible patient/physician view that weight counseling does not work, said Sciamanna.

"Doctors really need to know what to say... because these things are complicated and we're not trained to counsel. Unless you're going to change the way doctors are educated, we really need to know what exactly to say and what exactly to do," he added.

Sciamanna and colleagues undertook a cross-sectional analysis of the 1995-1996 and 2007-2008 National Ambulatory Medical Care Survey results to assess time trends in counseling for weight reduction, diet, and exercise during adult visits to primary care physicians.

A total of 15,753 patients were treated during the earlier study period, and 16,766 during the later period.

Few studies have investigated the impact of the obesity epidemic in this setting, maintain Sciamanna et al, despite large increases in population level of obesity and diabetes.

Between the earlier and later time periods, the researchers saw a decrease in the number of patient visits that included counseling for weight reduction, from 7.9% to 5.7%, diet, from 17.9% to 15.6%, and exercise, from 14.1% to 11.0%.

Analysis adjusted for potentially confounding patient, provider, and visit characteristics showed that patients seen in 1995-1996 were 84%, 61%, and 55% more likely to receive counseling for each of these situations, respectively, than patients seen in 2007 through 2008.

The study was limited by potential under-reporting by physicians of true obesity rates, and differing definitions of weight, diet, and exercise counseling programs, acknowledged Sciamanna.

"These data suggest that without assistance, physicians are not likely to be effective in addressing the obesity epidemic," says the research team.

Sciamanna suggested that "effective tools," such as targeted websites, could guide physicians in better treating their obese patients.

By Sarah Guy

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