Weight Counseling Goes Down

The amount of weight counseling offered by primary care physicians (PCPs) has gone down over the years despite the ongoing rise in the severe obesity and its consequences. A study published in the February issue of Medical Care found that patients seen in 2007-2008 had 46% lower odds of receiving weight counseling  than in 1995-96. Patients received counseling in only 6.2% of visits.

PCPs have been crucial in addressing and influencing significant public health successes such as reduced stroke and heart disease deaths due to the management and control of high cholesterol and high blood pressure. How are PCPs doing in obesity? The study by Jennifer Kraschnewski and colleagues suggests that PCPs are not ready to meet the challenge. Kraschewski believes that primary care providers lack effective tools to address the obesity epidemic.

The researchers examined data from the National Ambulatory Medical Care Survey for the years 1995-1996 and 2007-2008. This particular survey, which is national in scope, collects information about the delivery and use of outpatient medical care services in the United States. Researchers found that during the current obesity epidemic, patients seen in 2007-2008 had 46% lower odds of receiving weight counseling, despite 63.3% of adults having unhealthy weights or obesity in 2008.

In addition to the overall decline in counseling on weight, the decreases are even more noticeable in patients with obesity and weight-related comorbidities. For example, patients with high blood pressure were 46% less likely to receive counseling, and diabetes patients were 59% less likely to receive counseling. The reasons for this drop in counseling are unclear, according to the researchers. They suggest that barriers for physicians to offer weight counseling include pessimism that patients can change, time limitations during appointments due to addressing many health issues, and doctors’ belief that their training for lifestyle counseling is inadequate. The study concludes that effective and simple ways to implement interventions are needed to address weight counseling in the primary care setting.

Click here to read about the study from Penn State and here to read the study abstract in Medical Care.

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