Doc, How Do I Lose Weight?

Information on obesity care would be helpful to primary care doctors

(RxWiki News) More than one third of U.S. residents are obese. Yet the causes of obesity are complex and often debated by doctors. So are the treatments.

A recent study aimed to understand more about primary care doctors' attitudes toward obesity causes and treatments.

The survey revealed that the vast majority of primary care doctors in the US feel competent to advise patients on treatment for obesity.

However, fewer than half the doctors said they were usually successful in helping obese patients actually lose weight.

"Ask your doctor for weight loss resources."

The study, led by Sara Bleich, in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health in Baltimore, investigated doctors' knowledge and competence as it relates to obesity.

A total of 500 US primary care doctors participated in the online survey. The survey asked about four main areas:

  • causes of obesity
  • how competent doctors felt treating obese patients
  • which health professionals the doctors felt were most qualified to help obese patients reach and maintain a healthy weight
  • suggestions on how to improve care of obese patients

Regarding obesity causes, the doctors were specifically asked how much different causes contribute to obesity. These included over-consumption of food, restaurant or fast food eating, consumption of sugar-sweetened beverages, genetics and family history, and metabolic problems.

Overall, 75 percent of the doctors said that genetics or family history is an important contributor to obesity. Substantial numbers also said they believed metabolic issues (47 percent) and endocrine disorders (25 percent) are important causes of obesity.

The causes receiving the highest support were the individual behavioral factors. A total of 95 percent of the doctors said that restaurant and fast food eating was a major cause of obesity. Meanwhile, 94 percent attributed obesity in large part to consuming sugar-sweetened beverages.

Further, 99 percent believed that insufficient physical activity and that over-consumption of food were major causes. A lack of will power was also cited as an obesity cause by 89 percent of the doctors.

Doctors also saw environmental causes as reasons for obesity: 85 percent cited cultural factors; 75 percent cited a lack of information on good eating habits; 59 percent cited lack of access to healthy foods.

Younger doctors – those who completed medical school less than 20 years ago – were more likely to cite restaurant eating, lack of information on good eating habits and lack of access to healthy foods as major causes, compared to older doctors.

Nearly half (45 percent) of the doctors said a nutritionist or dietician was the most qualified to treat patients for obesity, followed by 39 percent who listed primary care doctors as most qualified to treat obesity.

While most of the doctors said they felt competent in giving exercise-related counseling (92 percent) or diet-related counseling (90 percent) to patients, only 44 percent reported that they are usually successful in helping obese patients lose weight.

Yet the doctors overwhelmingly said they need more resources for treating obesity. More than 90 percent said they would find it helpful to receive information on nutrition counseling, exercise counseling and patient care after bariatric surgery.

Only 64 percent were interested in information on weight loss medications while 85 percent would find it helpful to gain more information about patient eligibility for bariatric surgery. Also, 86 percent said information on motivational interviewing would be helpful.

Ways to improve obesity care noted by the doctors included BMI as a "vital sign" alongside blood pressure and others (93 percent), including specific diet or exercise tips in patients' charts (89 percent) and having scales that report BMI (85 percent).

The study was published December 20 in the journal BMJ Open. The research was funded by the National Heart, Lung and Blood Institute and a grant from the Health Resources and Services Administration. The authors declared no conflicts of interest.

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Review Date: 
January 10, 2013