Journal of General Internal Medicine

, Volume 22, Issue 4, pp 518–522 | Cite as

Perceived Barriers to Weight Management in Primary Care—Perspectives of Patients and Providers

  • Alicia R. RuelazEmail author
  • Pamela Diefenbach
  • Barbara Simon
  • Andy Lanto
  • David Arterburn
  • Paul G. Shekelle
Original Article



Despite the consequences of overweight and obesity, effective weight management is not occurring in primary care.


To identify beliefs about obesity that act as barriers to weight management in primary care by surveying both patients and providers and comparing their responses.


Anonymous, cross-sectional, self-administered survey of patients and providers of a Veteran’s Administration Primary Care Clinic, distributed at the clinic site.


Forty-eight Internal Medicine providers and 488 patients.


Beliefs, attitudes, and experiences with weight management as well as demographic characteristics were collected through a questionnaire.


Providers and patients differed significantly on many beliefs about weight. Providers were more likely than patients to perceive that patients lack self-control to stay on a diet and that fattening food in society and lack of time for exercise were prime factors in weight gain. They also expressed more interest in helping patients with weight management than patients desiring this. Patients were more likely to state that weight problems should be managed on one’s own, talking to a provider is not helpful, providers blame them for their weight problem, and that appointments contain sufficient time for weight discussion.


Providers and patients emphasize different barriers to weight management. Providers need to be aware of the beliefs that their patients hold to improve weight management discussions and interventions in primary care.


weight management primary care attitudes beliefs barriers 



This study was supported by the Veteran’s Administration Health Services Research and Development Center of Excellence for the Study of Provider Behavior, who provided methodologic and statistical support and coauthored the report. Dr. Ruelaz conducted this study as part of a psychosomatic medicine fellowship.

Potential Financial Conflicts of Interest

None disclosed


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Copyright information

© Society of General Internal Medicine 2007

Authors and Affiliations

  • Alicia R. Ruelaz
    • 1
    Email author
  • Pamela Diefenbach
    • 2
  • Barbara Simon
    • 3
  • Andy Lanto
    • 3
  • David Arterburn
    • 4
  • Paul G. Shekelle
    • 2
    • 3
  1. 1.Cedars-Sinai Medical CenterLos AngelesUSA
  2. 2.Greater Los Angeles Veteran’s Administration Healthcare SystemLos AngelesUSA
  3. 3.VA Health Services Research and Development Center of Excellence for the Study of Provider BehaviorLos AngelesUSA
  4. 4.Group Health Center for Health StudiesSeattleUSA

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