African Americans’ Perceptions of Physician Attempts to Address Obesity in the Primary Care Setting
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Obesity disproportionately affects African Americans and leads to several major co-morbidities. While guidelines recommend physicians identify obese patients and counsel them on weight management, little is known about how these efforts are received by patients.
To elucidate how obese, urban African American patients perceive the physician role in the treatment of obesity and to identify specific provider behaviors that may motivate or hinder attempts at weight loss.
Qualitative study involving eight focus groups.
Forty-three obese African-American patients recruited from academic internal medicine practices participated in focus groups between September 2007 and February 2008.
MEASUREMENTS AND MAIN RESULTS
Four broad themes emerged: (1) dislike of the word obese, (2) importance of the physician manner and timing when discussing weight, (3) necessity of a personalized approach in discussing weight management issues, and (4) variable response to scare tactics. Within each theme participants identified specific physician behaviors that were perceived as either motivating or hindering attempts at weight loss.
Physicians must be cognizant of the potential unintended consequences of the techniques they use to educate and counsel African-American men and women on obesity, particulary those that may be perceived as negative and act to further alienate obese patients from seeking the care they need.
- Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM. Prevalence of overweight and obesity in the United States, 1999–2004. JAMA. 2006;295(13):1549–55. CrossRef
- Kumanyika SK, Obarzanek E, Stevens VJ, Hebert PR, Whelton PK. Weight-loss experience of Black and White participants in NHLBI-sponsored clinical trials. Am J Clin Nutr. 1991;53(6 Suppl):1631S–8S.
- Wing RR, Anglin K. Effectiveness of a behavioral weight control program for Blacks and Whites with NIDDM. Diabetes Care. 1996;19(5):409–13. CrossRef
- Parikh M, Lo H, Chang C, Collings D, Fielding G, Ren C. Comparison of outcomes after laparoscopic adjustable gastric banding in African Americans and Whites. Surg Obes Relat Dis. 2006;2(6):607–10. discussion 610–2. CrossRef
- Anderson WA, Greene GW, Forse RA, Apovian CM, Istfan NW. Weight loss and health outcomes in African Americans and Whites after gastric bypass surgery. Obesity. 2007;15(6):1455–63. CrossRef
- U.S. Preventive Services Task Force. Screening for obesity in adults: Recommendations and rationale. Rockville, MD: Agency for Healthcare Research and Quality;2003.
- Sciamanna CN, Tate DF, Lang W, Wing RR. Who reports receiving advice to lose weight? Results from a multi-state survey. Arch Intern Med. 2000;160(15):2334–9. CrossRef
- Ruser CB, Sanders L, Brescia GR, et al. Identification and management of overweight and obesity by internal medicine residents. J Gen Intern Med. 2005;20(12):1139–41. CrossRef
- Anis NA, Lee RE, Ellerbeck EF, Nazir N, Greiner KA, Ahluwalia JS. Direct observation of physician counseling on dietary habits and exercise: Patient, physician, and office correlates. Prev Med. 2004;38(2):198–202. CrossRef
- Foster GD, Wadden TA, Makris AP, et al. Primary care physicians’ attitudes about obesity and its treatment. Obes Res. 2003;11(10):1168–77. CrossRef
- Alexander SC, Ostbye T, Pollak KI, Gradison M, Bastian LA, Brouwer RJ. Physicians’ beliefs about discussing obesity: Results from focus groups. Am J Health Promot. 2007;21(6):498–500.
- Wadden TA, Anderson DA, Foster GD, Bennett A, Steinberg C, Sarwer DB. Obese women’s perceptions of their physicians’ weight management attitudes and practices. Arch Fam Med. 2000;9:854–60. CrossRef
- Ruelaz AR, Diefenbach P, Simon B, Lanto A, Arterburn D, Shekelle PG. Perceived barriers to weight management in primary care: Perspectives of patients and providers. J Gen Intern Med. 2007;22(4):518–22. CrossRef
- Greiner KA, Born W, Hall S, Hou Q, Kimminau KS, Ahluwalia JS. Discussing weight with obese primary care patients: Physician and patient perceptions. J Gen Intern Med. 2008;23(5):581–7. CrossRef
- Forman-Hoffman V, Little A, Wahls T. Barriers to obesity management: A pilot study of primary care clinicians. BMC Fam Pract. 2006;7:35. CrossRef
- Wadden TA, Didie E. What’s in a name? Patients’ preferred terms for describing obesity. Obes Res. 2003;11(9):1140–6. CrossRef
- Rand CSW, MacGregor AMC. Morbidly obese patients’ perceptions of social discrimination before and after surgery for obesity. South Med J. 1990;83:1390–5.
- McAffe L. Discrimination in medical care. Healthy Weight J. 1997;11:96–7.
- Kaminsky J, Gadaleta D. A study of discrimination within the medical community as viewed by obese patients. Obes Surg. 2002;12:14–18. CrossRef
- Cossrow NHF, Jeffery RW, McGuire MT. Understanding weight stigmatization: A focus group study. J Nutr Educ. 2001;33(4):208–14. CrossRef
- Anderson DA, Wadden TA. Bariatric surgery patients’ views of their physicians’ weight-related attitudes and practices. Obes Res. 2004;12:1587–95. CrossRef
- Rothman AJ, Salovey P. Shaping perceptions to motivate healthy behavior: the role of message framing. Psychol Bull. 1997;121(1):3–19. CrossRef
- Anderson DA, Wadden TA. Treating the obese patient. Suggestions for primary care practice. Arch Fam Med. 1999;8(2):156–67. CrossRef
- Emmons KM, Rollnick S. Motivational interviewing in health care settings: Opportunities and limitations. Am J Prev Med. 2001;20(1):68–74. CrossRef
- Waldrop J. Behavior change in overweight patients. Motivational interviewing as a primary care intervention. Adv Nurse Pract. 2006;14(8):23–7.
- Potter MB, Vu JD, Croughan-Minihane M. Weight management: what patients want from their primary care physicians. J Fam Pract. 2001;50(6):513–8.
- Hill D, Chapman S, Donovan R. The return of scare tactics. Tob Control. 1998;7(1):5–8. CrossRef
- Mercer S, Tessier S. A qualitative study of general practitioners’ and practice nurses’ attitudes to obesity management in primary care. Health Bull. 2001;59:248–53.
- Befort CA, Greiner KA, Hall S, et al. Weight-related perceptions among patients and physicians. How well do physicians judge patients’ motivation to lose weight? J Gen Intern Med. 2006;21:1086–90. CrossRef
- African Americans’ Perceptions of Physician Attempts to Address Obesity in the Primary Care Setting
Journal of General Internal Medicine
Volume 24, Issue 5 , pp 579-584
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