Patient and physician characteristics associated with the provision of weight loss counseling in primary care

Abstract

Background A variety of physician and patient characteristics may influence whether weight loss counseling occurs in primary care encounters. Objectives This study utilized a cross-sectional survey of primary care patients, which examined patient characteristics, physician characteristics, and characteristics of the physician-patient relationship associated with weight loss counseling and recommendations provided by physicians. Participants Participants (N=143, mean age=46.8 years, mean BMI=36.9 kg/m2, 65% Caucasian) were overweight and obese primary care patients participating in a managed care weight loss program. Measures Participants completed self-report surveys in the clinic prior to the initial weight loss session. Surveys included items assessing demographic/background characteristics, weight, height, and a health care questionnaire evaluating whether their physician had recommended weight loss, the frequency of their physicians’ weight loss counseling, and whether their physician had referred them for obesity treatment. Results Patient BMI and physician sex were most consistently associated with physicians’ weight loss counseling practices. Patients seen by female physicians were more likely to be told that they should lose weight, received more frequent obesity counseling, and were more likely to have been referred for obesity treatment by their physician. Length and frequency of physician-patient contacts were unrelated to the likelihood of counseling. Conclusions These findings add to previous evidence suggesting possible differences in the weight loss counseling practices of male and female physicians, although further research is needed to understand this potential difference between physicians.

Physicians’ personal beliefs about weight-related care and their associations with care delivery: The U.S. National Survey of Energy Balance Related Care among Primary Care Physicians

“…Considering the increased frequency that these PCPs see their patients, specialty societies for paediatricians [53] and OB/GYNs [54] have a great opportunity and responsibility to insure their care providers are delivering consistent, impactful messages regarding the promotion of healthy weight-related behaviours. Our findings that female PCPs were significantly more likely to agree with personal belief statements are consistent with previous research highlighting differences in the weight-related counselling practices of male and female physicians [25]. Others have found that female PCPs are more knowledgeable about physical activity and healthy BMI guidelines [55], and more likely to counsel and refer patients for weight related treatment than males [25].…”

“…Our findings that female PCPs were significantly more likely to agree with personal belief statements are consistent with previous research highlighting differences in the weight-related counselling practices of male and female physicians [25]. Others have found that female PCPs are more knowledgeable about physical activity and healthy BMI guidelines [55], and more likely to counsel and refer patients for weight related treatment than males [25].…”

“…It is possible that these personal beliefs and attitudes negatively influence the provision of weight-related care [20]. Previous research has described the perceived knowledge, skill, and attitudes of health care providers about the treatment of obesity [16][17][18][19][20][21][22][23][24], and documented the rates of weight-related care delivery [3,4,13,14,25]. In general, health care practitioners expressed concerns about their lack of effective strategies to address weight-related issues [16][17][18][19]26,27], and lacked confidence in their counselling skills [20,21,28].…”

Provider attitudes and practice patterns of obesity management with pharmacotherapy

“…Dutton et al. () also found that a higher BMI (>35 kg/m 2 ) was associated with receiving more frequent weight loss counseling. According to our findings, it was evident that the degree of obesity was a pertinent factor for prescribing medication.…”

Eating behaviors among low-income obese adults in the United States: Does health care provider's advice carry any weight

“…Some providers feel they lack the knowledge and resources to provide nutrition or weight loss advice (Kolasa and Rickett, 2010; Puhl and Heuer, 2009). Physician and patient characteristics may also play a role in who received weight loss advice; Dutton et al found that female physicians were more likely to provide weight loss advice (Dutton et al, 2014). Unfortunately, even health professionals have been found to carry implicit biases and negative attitudes regarding those who are obese, which may prevent them from initiating weight loss advice (Puhl and Heuer, 2009; Schwartz et al, 2003; Teachman and Brownell, 2001).…”