Focused Attention

Obesity Diagnosis: Paying Attention Pays Benefits

We’re learning the hard way that neglecting a health problem doesn’t lead it to “go away.” In fact, it can come back to bite you. But on the other hand, paying attention to a problem can pay big benefits. And so it is with diagnosing obesity and giving it real medical attention. A new study in Obesity offers evidence. When healthcare providers diagnose obesity, the odds for clinical improvement go up.

The only problem is that providers, more often than not, don’t bother with the diagnosis.

An Observational Study of 688,878 Patients

Diagnosis of Obesity Predicting Weight LossElizabeth Ciemins and colleagues analyzed the medical records of 688,878 patients from 15 health systems. They looked for a diagnosis of obesity on a medical claim or problem list in patients with a BMI of 30 or more. They also looked for evidence that patients lost a clinically significant amount of weight within nine to fifteen months after the diagnosis.

What they found was a 30 percent improvement in the odds that patients would lose weight if the physician recorded a diagnosis of obesity. No surprise here. Paying attention to a problem can indeed lead to finding a solution.

In the logistic regression modeling, a few other variables are worth noting. For one thing, prescribing an anti-obesity medication was the strongest predictor of clinical improvement in weight status. Other factors seemed to play a role, too – being female, having type 2 diabetes, Medicare or Medicaid insurance, and more follow-up visits. Each of these factors raise questions that deserve follow-up. Bear in mind, these are observational findings, not evidence for causal relationships.

Skipping the Diagnosis

Obesity is a diagnosis that many physicians skip past. Only 45 percent of the patients with a BMI over 30 had that diagnosis. The authors note:

“Low diagnosis rates may be due to a lack of recognition of obesity as a disease and concern about offending patients.”

Another factor is that many providers feel ill-prepared to deliver obesity care that will actually help. It has to go beyond merely instructing the patient to lose weight.

None of this should be surprising. On many levels, we are learning that health problems don’t go away because we dismiss, neglect, or deny them. In fact, we’re seeing that they get worse. Obesity is no exception. Diagnosis and the provision of care makes a difference.

Click here for the study and here for more on diagnosing obesity.

Focused Attention, photograph © Nikolay Gromin / flickr

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October 8, 2020