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Discussing Weight with Obese Primary Care Patients: Physician and Patient Perceptions

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Abstracts

Objective

To evaluate patient–provider agreement on whether weight and related behaviors were discussed during routine visits.

Design

Post-visit survey assessments of patients and providers.

Participants

Obese patients make up the majority of all patients seen in primary care (PC). The patients and physicians were recruited at the time of PC visits.

Measurements and Main Results

Percent patient–physician agreement and patient, provider and practice characteristics associated with agreement. Patients (456) and physicians (30) agreed about whether or not they discussed weight, physical activity (PA), and diet for 61% of office visits. There was disagreement on one of the items (weight, PA, or diet) for 23% of office visits, and for 2 or more of the items for 16% of the visits. Agreement was relatively greater for discussing weight than for discussing diet or physical activity. Physicians reported discussing weight issues more often than did patients. Overall patient–physician agreement was 0.51–0.59 (weighted Kappa statistic). In a multivariate analyses of factors associated with patient–physician agreement, health insurance (odds ratio [OR]=3.67, p value = 0.002), physician description of patient weight status (OR = 2.27, p value = 0.002), patient report of how weight relates to health (OR = 1.70, p value = 0.04), and female patient gender (OR = 1.62, p = value = 0.02) were significantly related to agreement.

Conclusions

Patients and providers disagreed about whether or not weight issues were discussed in a large number of primary care encounters in this study. Physicians may be able to improve care for their obese patients by focusing discussions on specific details of diet and physical activity behaviors, and by clarifying that patients perceive weight-related information has been shared.

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Acknowledgments

This study was supported by an award from the Sunflower Foundation, Topeka, Kansas and student stipend support from the Baker Trust, LaCrosse, Kansas. The study was also made possible by the generous in-kind contributions from medical student participants and physician members of the Kansas Physicians Engaged in Prevention Research Program.

Conflict of Interest Statement

None disclosed.

Author information

Authors and Affiliations

  1. Department of Family Medicine, University of Kansas Medical Center, Kansas City, KS, USA

    K. Allen Greiner MD, MPH & Kim S. Kimminau PhD

  2. Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS, USA

    K. Allen Greiner MD, MPH, Sandra Hall PHD, Qingjiang Hou MS & Kim S. Kimminau PhD

  3. Kansas Masonic Cancer Research Institute, University of Kansas Medical Center, Kansas City, KS, USA

    K. Allen Greiner MD, MPH, Sandra Hall PHD & Kim S. Kimminau PhD

  4. Department of Psychology, Baker University, Baldwin, KS, USA

    Wendi Born PhD

  5. Executive Director, Office of Clinical Research, University of Minnesota Academic Health Center, Minneapolis, MN, USA

    Jasjit S. Ahluwalia MD, MPH, MS

  6. Family Medicine and Preventive Medicine, University of Kansas Medical Center, Kansas City, KS, USA

    K. Allen Greiner MD, MPH

Authors
  1. K. Allen Greiner MD, MPH
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  2. Wendi Born PhD
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  6. Jasjit S. Ahluwalia MD, MPH, MS
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Corresponding author

Correspondence to K. Allen Greiner MD, MPH.

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Greiner, K.A., Born, W., Hall, S. et al. Discussing Weight with Obese Primary Care Patients: Physician and Patient Perceptions. J GEN INTERN MED 23, 581–587 (2008). https://doi.org/10.1007/s11606-008-0553-9

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  • DOI: https://doi.org/10.1007/s11606-008-0553-9

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