Understanding Weight Management Preferences of Obese Patients in the Primary Care Setting

Introduction: More than one-third of adults in the United States are obese, which contributes to the high prevalence of cardiovascular disease, type 2 diabetes, hypertension, and other preventable disorders.  Recent updates to the U.S. Preventative Services Task Force recommendations emphasize the importance of obesity screening and treatment in adults.  While a large amount of research is available regarding the medical benefits of maintaining a healthy weight, there is minimal data on patient attitudes toward weight management in primary care.  A better understanding of patient perceptions of weight loss strategies will reduce obesity-related morbidity and improve overall health in the community.

Methods: Individual, structured interviews were conducted with 10 patients over the age of 18 years who had a BMI of 30 kg/m² or greater.  These patients were selected as a convenience sample from an academic-based family medicine practice. Information from these interviews was used to develop a survey, which was later distributed to all adult patients visiting the family medicine practice during a 3-day period.  The survey addressed weight management in primary care, and the compiled data was filtered by standard BMI grouping.  Participation was optional, and no incentives were offered to those who completed the survey.

Results: Of the 560 adult patients who visited the practice, 103 completed the survey.  Respondents had an average age of 42.4 years and an average BMI of 26.8 kg/m².  Of the 78 people who were able to identify at least one exercise, diet, or weight goal, 91% had at least one barrier that slowed their progress.  84% of patients stated that a physician could not help them reach their weight goals, while 16% stated that a physician could be of assistance in managing their weight.  Weight loss programs were ranked as the most effective in weight management, while physician help was ranked the lowest.  Obese patients were least likely to schedule multiple appointments with their physician to help manage weight, as compared to the other options presented in the survey.

Conclusions: The USPSTF recommendations state that high intensity intervention, defined as 12 – 26 sessions per year, could help reduce obesity in adults.  The results of this study suggest that a majority of patients are unlikely to schedule multiple appointments with their physician to discuss weight management, and that they believe this option would be ineffective.  Data from this survey also suggests that patients are interested in coordinating care with nutritionists, personal trainers, and weight loss programs to supplement the advice they receive from their physician.  Partnerships between physicians and community/commercial programs could improve weight management practice.