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Primary care docs uncertain about weight counseling


Primary care physicians say they may not be the best healthcare professionals to give weight-related counseling, according to a study.

Researchers examined primary care physician perspectives on causes of and solutions to obesity care and identified differences in these perspectives by number of years since completion of medical school. They found that only 44% of primary care physicians reported success in helping obese patients lose weight and that primary care physicians identified nutritionists and dietitians as the most qualified providers to care for obese patients.

“In order to begin improving obesity care, medical education should focus on enhancing those obesity-related skills [that]primary care physicians feel most qualified to deliver, as well as changing the composition of healthcare teams and practice resources,” Sara Bleich, PhD, the study’s lead author and an assistant professor in the Johns Hopkins Bloomberg School of Public Health, said in a news release.

Bleich noted several training- and practice-based changes cited by primary care physicians as worth implementing: including body mass index as a vital sign (93% of respondents), including diet and exercise tips in patients’ charts (89%), having scales to calculate BMI (85%) and adding BMI to patients’ charts (69%).

Bleich and colleagues conducted a national cross-sectional survey of 500 general practitioners, family practitioners and general internists over a three-week period in early 2011. The researchers evaluated primary care physician perspective on the causes of obesity, competence in treating obese patients, perspectives on the health professional most qualified to help obese patients lose or maintain weight, and solutions for improving obesity care.

They found that primary care physicians overwhelmingly supported additional training such as nutrition counseling and practiced-based changes such as having scales report body mass index. Primary care physicians with fewer than 20 years since completion of medical school were more likely to identify lack of information about good eating habits and lack of access to healthy food as important causes of obesity.

“There are few differences in primary care physician perspectives about the causes of obesity or solutions to improve care, regardless of when they completed medical school, suggesting that obesity-related medical education has changed little over time,” Bleich said. “Physicians who completed medical school more recently reported feeling more successful helping obese patients lose weight. However, no matter when they completed medical school they overwhelmingly supported additional training and practice-based changes to help them improve their obesity care.”

The study appeared Dec. 20 in the journal BMJ Open. A PDF of the study is available at


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