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DOI: 10.1177/0145721706290437
Obesity ManagementPhysician Practice Patterns and Patient PreferenceFrom the Albert Einstein College of Medicine, the Bronx, New York. Correspondence to Nichola J. Davis, MD, MS, Albert Einstein College of Medicine, Montefiore Medical Center, 1300 Morris Park Avenue, Mazer Building 216, Bronx, NY 10461 (ndavis{at}montefiore.org). Purpose The purpose of this study was to assess inner-city clinic patient attitudes about weight loss counseling and to assess practice behaviors of primary care physicians in residency training. Methods
This is a cross-sectional survey of consecutive patients attending an
outpatient internal medicine resident continuity clinic in the Bronx, New
York. Participants completed a 30-item questionnaire; a 17-item Quick Weight,
Activity & Excess Screener (WAVE); and 13 items to assess patients'
attitudes about the physician's role in weight management. A chart review was
conducted to ascertain resident practice patterns. Relationships of
categorical data were evaluated using Results Chart reviews (n = 84) indicated that 80% of patients were either obese or overweight; 21% of obese patients and 11% of overweight patients had the diagnosis documented. Of the obese patients (n = 42), 17% had dietitian referrals and 36% had an indication of physician weight loss recommendation. A patient survey indicated that 86% of obese patients wanted to lose weight, 64% wanted a dietitian referral, and 62% felt that their physician could help with weight loss. Obese patients were significantly more likely to receive weight loss recommendations than were overweight patients, but frequency of visits and the diagnosis of diabetes did not increase the likelihood that weight would be addressed. Conclusions Physicians need to address how to manage obesity including assessing patient attitudes about making lifestyle changes and using dietitian and other referrals for weight reduction counseling.
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