Obesity management and continuing medical education in primary care: results of a Swiss survey

Abstract

BackgroundThe worldwide increase in obesity is becoming a major health concern. General practitioners (GPs) play a central role in managing obesity. We aimed to examine Swiss GPs self-reported practice in diagnosis and treatment of obesity with a special focus on the performance of waist measurement.MethodsA structured self-reported questionnaire was mailed to 323 GPs recruited from four urban physician networks in Switzerland. Measures included professional experience, type of practice, obesity-related continuing medical education (CME) and practice in dealing with obesity such as waist measurement. We assessed the association between the performance of waist measurement and obesity-related CME by multivariate ordered logistic regression controlling for GP characteristics as potential confounders.ResultsA total of 187 GPs responded to the questionnaire. More than half of the GPs felt confident in managing obesity. The majority of the GPs (73%) spent less than 4 days in the last 5 years on obesity-related CME. More than half of GPs gave advice to reduce energy intakes (64%), intakes of high caloric and alcoholic drinks (56%) and to increase the physical activity (78%). Half of the GPs seldom performed waist measurement and documentation. The frequency of obesity-related CME was independently associated with the performance of waist measurement when controlled for GPs' characteristics by multivariate ordered logistic regression.ConclusionsThe majority of GPs followed guideline recommendations promoting physical activity and dietary counselling. We observed a gap between the increasing evidence for waist circumference assessment as an important measure in obesity management and actual clinical practice. Our data indicated that specific obesity-related CME might help to reduce this gap.

Identification of Obesity and Cardiovascular Risk in Ethnically and Racially Diverse Populations

“…43 Unfortunately, roughly half of primary care physicians seldom or never measure WC. 44,45 Furthermore, errors in measurement and inconsistency of technique are common. 46,47 The NIH/NHLBI cut points that distinguish between people at higher and lower cardiovascular risk are >102 cm (40") for men and >88 cm (35") for women.…”

Nutrition and physical activity counselling by general practitioners in Lithuania, 2000–2014

“…Good GP knowledge and counselling skills are essential for effective consultation. Providing sufficient training in medical schools and in continuous medical education on how to discuss nutrition and physical activity for weight management and developing the practical tools to support counselling in primary health care may help to increase the frequency of giving advice [8, 32].…”

Nurses’ self-efficacy and practices relating to weight management of adult patients: a path analysis

“…Although most health professionals hold favorable attitudes concerning their role in the prevention and treatment of obesity, many have expressed a lack of confidence in their ability to manage obese patients, and their actual professional weight management practices fall below the recommendations set out in the evidence-based guidelines of several countries, for example, health professionals should use every opportunity to help patients with changes to their lifestyles (dietary advice and exercise) [ 2 - 4 ]. This is evident from studies of patients [ 5 - 7 ], physicians [ 8 - 12 ] and nurses [ 13 , 14 ]. Patient surveys have suggested that less than a half of obese patients were advised by their physicians to lose weight [ 5 - 7 ] with a minority of physicians reporting confidence in helping obese patients lose weight [ 8 ], half performing waist measurement [ 12 ], and less than half always providing specific guidance on diet, physical activity or weight control for their adult patients [ 11 ].…”

“…This is evident from studies of patients [ 5 - 7 ], physicians [ 8 - 12 ] and nurses [ 13 , 14 ]. Patient surveys have suggested that less than a half of obese patients were advised by their physicians to lose weight [ 5 - 7 ] with a minority of physicians reporting confidence in helping obese patients lose weight [ 8 ], half performing waist measurement [ 12 ], and less than half always providing specific guidance on diet, physical activity or weight control for their adult patients [ 11 ]. These findings are consistent with those for nurses with few routinely using the body mass index (BMI) to make clinical judgments of weight status or obesity [ 13 , 14 ].…”