Patient perception of obesity versus physician documentation of obesity: A quality improvement study

Abstract

As the prevalence of obesity increases, the prevalence of associated comorbid diseases, obesity‐related mortality rates and healthcare costs rise concordantly. Two main factors that hinder efforts to treat obesity include a lack of recognition by patients and documentation by physicians. This study evaluates the relationship between patient perception of obese weight and physician documentation of obesity. This quality improvement observational study surveyed patients of an academic internal medicine clinic on their perception of obesity. Responses were compared to longitudinal physician documentation of obesity and body mass index (BMI). A total of 59.9% of patients with obesity perceived their weight as obese. While 33.7% of patients with a BMI of 30 to 34.9 kg/m2 perceived themselves as having obesity, 71.4% of patients with a BMI of 45 to 49.9 kg/m2 perceived themselves as having obesity. A total of 42.4% of patients with obesity had physician documentation of obesity in the last year. While 25% of patients with a BMI of 30 to 34.9 kg/m2 had physician documentation of obesity, 85.7% of patients with a BMI of 45 to 49.9 kg/m2 had physician documentation of obesity. For patients with a BMI ≥50 kg/m2, 52.9% perceived their weight to be obese and 76.5% had physician documentation of obesity in the last year. Both patient perception and physician documentation of obesity were significantly less than the prevalence of obesity. Patient perception of obesity and provider documentation of obesity increased as BMI increased until a BMI ≥50 kg/m2. Both patients and providers must improve recognition of this disease.

Misperceptions and barriers to obesity management: Italian data from the ACTION-IO study

“…Despite the availability of evidence-based policy guidelines, the increasing prevalence of obesity suggests the poor implementation of these recommendations. In practice, suboptimal care is often provided to PwO [15][16][17], as demonstrated by the low rates of obesity diagnosis, documentation and management [18,19], and inadequate knowledge of obesity treatment guidelines [20]. Healthcare professionals (HCPs) are uniquely positioned to identify, evaluate and manage obesity.…”

“…Barriers to effective communication between PwO and HCPs include uncertainty regarding patient and HCP roles for initiating weight discussions [22], the belief among PwO that it is their responsibility to manage their weight, HCPs' discomfort with broaching the topic, fear of offending the patient, especially considering patients often have access to their medical records, and misperceptions regarding patient disinterest and motivation for losing weight [17][18][19]. Furthermore, a disconnect between HCPs' confidence in their ability to manage patients with excess weight and the effectiveness of PwO in achieving weight loss goals has been documented [23].…”

Nutritional and Socioeconomic Determinants of Overweight and Obesity in the French Amazon: The Health Barometer Study

“…Medical information on obesity can improve the patient’s perception of his or her obesity, but this information is not provided in French Guiana due to the very low number of nutritional specialists ( 24 ). In this study, women belonging to the Creole community were more likely to underestimate their body weight.…”

Experience and expectations of patients on weight loss: The Learning Health System Network Experience

“…Studies evaluating perceptions of individuals who have overweight or obesity had consisted of small size and had yielded contrasting observations, from those who had realistic perception of obesity and recognized the need to lose weight, to those whose perception of obesity was below its true prevalence . To address this limitation and obtain a more robust insight on the personal experiences and expectations regarding weight loss among patients who have overweight and obesity, data were analysed from a survey of primary care patients within the Learning Health Systems Network (LHSNet).…”