Factors Associated with the Accurate Diagnosis of Obesity

Abstract

Obesity is a growing epidemic, yet few patients with obesity receive a clinical diagnosis of obesity or appropriate counseling. We examined the socioeconomic and demographic factors associated with the accurate diagnosis of obesity during ambulatory care visits. We used data from the National Hospital Ambulatory and National Ambulatory Medical Care Surveys (NHAMCS and NAMCS) to determine if a patient with obesity had been clinically diagnosed with obesity during the visit by either of the following: (1) a diagnosis listed in the patient's record; or (2) the provider's answer to the question "despite the diagnoses listed, does this patient have obesity?" We used multivariate models to examine the association between the accurate diagnosis of obesity and socioeconomic and demographic factors. We examined 885,291,770 weighted office visits involving individuals 5 years of age and older between 2006 and 2010. Providers were less likely to diagnose obesity at office visits involving children (5-12 years) with obesity (23.4 %) than at visits for adolescents (13-21 years; 39.7 %), young adults (22-34 years; 45.4 %), adults (35-64 years; 43.9 %) or elderly adults (≥65 years; 39.6 %; P < 0.001 for all). Individuals with obesity residing in more highly educated areas were more likely to be diagnosed than those living in less highly educated areas (44.2 vs. 40.9 %; AOR 1.4; 95 % CI 1.2-1.6). Males with obesity were less likely to be diagnosed than females with obesity (36.1 vs. 45.8 %; AOR 0.7; 95 % CI 0.6-0.8). After controlling for socioeconomic-status we did not find a consistent difference in the diagnosis of obesity by race. The diagnosis of obesity was made at less than half of all office visits involving patients with obesity. Children, adolescents, elderly, males, and those living in less educated areas were less likely to be accurately diagnosed with obesity.

Couple and family interventions for high mortality health conditions: A strategic review (2010–2019)

“…Additionally, other conditions (e.g., cirrhosis, septicemia, and hypertension) are in the CDCs top 20 high mortality conditions for adults (Kochanek et al, 2019), but not included in this article due to the sheer size and rigor of covering more than the top ten health conditions for adults. While the CDC (2019) does not recognize obesity as a top mortality condition, likely because pathologists or morticians do not often consider obesity itself as a cause of death (Miller et al, 2016), it is recognized as a leading precursor to preventable death (e.g., heart disease, diabetes, nephritis/nephrosis; Censin et al, 2019) and thereby included in this review.…”

Paediatric obesity: Documentation, screening, and pharmacotherapy in a national cohort

“…The rate of documentation of diagnosis of obesity in our study (55.8%) was higher than previously reported for this age range for a national cohort. 12 Documentation of obesity diagnosis has been associated with improved rates of weight loss, referrals to obesity medicine specialists, and improved nutritional and physical activity counselling. 13,[26][27][28] Presence of an ICD-10 code for obesity in our cohort was associated with increased odds of having screening lab work completed and of being prescribed an AOM.…”

Medical Weight Problem Diagnosis and Minority Women’s Desire for Thinness

“…Despite the existence of medical guidelines for obesity diagnosis and management for adults [5][6][7][8], physicians' efforts to prevent and treat obesity have been challenging [7,9]. Between 30% and 50% of people with overweight (PwO) are estimated to have received a medical weight problem diagnosis from their primary-care physician [5,8,10,11]. The underdiagnosis of obesity in primary care settings [12,13] may suggest to PwO that they do not have a weight problem or that they do not need to seek weight control advice [14,15].…”

“…Physicians' barriers to providing an obesity diagnosis and weight control advice have been extensively investigated. The identified barriers are mostly related to providers' attitudes (e.g., limited competency in obesity counseling and treatment, beliefs that obesity is PwO's responsibility), and practices (e.g., prioritizing treatment of medical conditions over weight control concerns and limited consultation time with patients) [5,11,[16][17][18][19][20]. Despite these barriers, research indicates that physicians' attention to obesity issues helps to increase overweight and obese patients' intention to lose weight, weight loss initiation, and weight loss maintenance [5,21].…”