Facilitating Factors and Barriers to Weight Management in Women: Physician Perspectives

Abstract

Journal of Patient-Centered Research and Reviews ( JPCRR) is a peerreviewed scientific journal whose mission is to communicate clinical and bench research findings, with the goal of improving the quality of human health, the care of the individual patient, and the care of populations. Recommended CitationWalker RE, Kusch J, Fink JT, Nelson DA, Morris G 3rd, Skalla J, Cisler RA. Facilitating factors and barriers to weight management in women: physician perspectives. J Patient Cent Res Rev. 2018;5:18-27. doi: 10.17294/2330-0698 4,5 For women, prevalence of overweight and obesity has varied from 64.1% to 65.8% to 63.7% in 2007-2008, 2009-2010, and 2011-2012, respectively. 4-6 Addressing overweight and obesity in both men and women has been a challenge for medical and public health practice, but perhaps more so in women given the race-by-sex differences observed for these conditions. 5,6 Using national data from 2011-2012, Ogden and colleagues reported age-adjusted overweight and obesity prevalence of 69.2%, 78.6%, PurposeThe complexity of addressing overweight and obesity in women has been an ongoing public health and health care challenge. While the mechanism for addressing overweight and obesity in women remains unclear, it has been speculated that disparities in overweight and obesity by race and gender contribute to the complexity. The purpose of the present study was to examine perceptions of primary care physicians when discussing weight management with their patients. MethodsWe conducted focus group discussions exploring facilitators and barriers to discussing weight management and weight loss among women patients. Participants included 18 family medicine and internal medicine physicians who were recruited using a snowball sampling technique from two large urban institutions. Focus group discussions were transcribed verbatim. Responses were then codified and analyzed in frequency of occurrence using specialized computer software. ResultsNine themes emerged from group discussions. These recurring themes reflected three overarching critical points: 1) potential utility of the primary care setting to address weight management; 2) the importance of positive patient-provider communication in supporting weight loss efforts; and 3) acknowledgement of motivation as intrinsic or extrinsic, and its role in obesity treatment. ConclusionsPhysician perceptions of their own lack of education or training and their inability to influence patient behaviors play crucial roles in discussing weight management with patients. (J Patient Cent Res Rev.

2021 EULAR recommendations regarding lifestyle behaviours and work participation to prevent progression of rheumatic and musculoskeletal diseases

“…Lifestyle modifications potentially have substantial benefits to overall and RMD-specific health and should be a recurrent and frequent theme in discussions between people with RMDs and health professionals. Furthermore, given the complexity of RMD conditions (eg, early vs established disease, disease flares) and the potential interactions between lifestyle modifications, current health condition and medical treatment, people with RMDs may need guidance and support from health professionals to implement a combination of healthy lifestyle changes 32–34. This guidance and support should stem from a comprehensive management plan known to all health professionals directly involved in the disease management of people with RMDs.…”

Patient Barriers for Weight Management Among African American Women

“…Alternatively, from the physician's perspective, studies have referenced physicians feeling they had insufficient training to have meaningful and impactful conversations regarding weight management with patients. 20 Additionally, physicians often perceive patients as lacking motivation to address their weight rather than considering potential social and ecological barriers to proper weight management. 20 Such discrepancies present in perceptions between patients and physicians builds a picture of present deficits in patient-provider communication, and potentially highlights areas for targeted improvement.…”

Imagine a World …

“…Walker et al describe physician perspectives on barriers to weight management for women. 13 Out of focus groups conducted with internal and family medicine physicians, a few critical themes emerged --involvement of the primary care setting, communication between patient and provider, and acknowledgment of patient motivation to manage weight. The researchers concluded that a multidisciplinary approach will be crucial to making progress on this often sensitive but serious health concern.…”