Abstract
Background
Despite the consequences of overweight and obesity, effective weight management is not occurring in primary care.
Objective
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.
Design
Anonymous, cross-sectional, self-administered survey of patients and providers of a Veteran’s Administration Primary Care Clinic, distributed at the clinic site.
Subjects
Forty-eight Internal Medicine providers and 488 patients.
Measurements
Beliefs, attitudes, and experiences with weight management as well as demographic characteristics were collected through a questionnaire.
Results
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.
Conclusion
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.
Similar content being viewed by others
References
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;295:1549–55.
Das SR, Kinsinger LS, Yancy WS Jr, et al. Obesity prevalence among veterans at Veterans Affairs medical facilities. Am J Prev Med. 2005;28:291–4.
Stafford RS, Farhat JH, Misra B, Schoenfeld DA. National patterns of physician activities related to obesity management. Arch Fam Med. 2000;9:631–8.
Sciamanna CN, Tate DF, Lang W, Wing RR. Who reports receiving advice to lose weight? Results from a multistate survey. Arch Intern Med. 2000;160:2334–9.
Ruser CB, Sanders L, Brescia GR, et al. Identification and management of overweight and obesity by internal medicine residents. J Gen Intern Med. 2005;20:1139–41.
American Medical Association, Robert Wood Johnson Foundation. Assessment and Management of Adult Obesity—A Primer for Physicians, Booklet 1. American Medical Association Roadmaps for Clinical Practice: Robert Wood Johnson Foundation; 2003:iii,10.
Price JH, Desmond SM, Krol RA, Snyder FF, O’Connell JK. Family practice physicians’ beliefs, attitudes, and practices regarding obesity. Am J Prev Med. 1987;3:339–45.
Harris SB, Petrella RJ, Lambert-Lanning A, Leadbetter W, Cranston L. Lifestyle management for type 2 diabetes. Are family physicians ready and willing? Can Fam Physician. 2004;50:1235–43.
Johnson CA, Corrigan SA, Dubbert PM, Gramling SE. Perceived barriers to exercise and weight control practices in community women. Women Health. 1990;16:177–91.
Pikholz C, Swinburn B, Metcalf P. Under-reporting of energy intake in the 1997 National Nutrition Survey. N Z Med J. 2004;117(1202):U1079.
Poppitt SD, Swann D, Black AE, Prentice AM. Assessment of selective under-reporting of food intake by both obese and non-obese women in a metabolic facility. Int J Obes Relat Metab Disord. 1998;22(4):303–11.
Bray, George. Etiology and natural history of obesity. UpToDate. February 17, 2006.
Wadden TA, Berkowitz RI, Womble LG, et al. Randomized trial of lifestyle modification and pharmacotherapy for obesity. N Engl J Med. 2005;353:2111–20.
Acknowledgement
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
Author information
Authors and Affiliations
Corresponding author
Additional information
An erratum to this article can be found at http://dx.doi.org/10.1007/s11606-007-0236-y
Rights and permissions
About this article
Cite this article
Ruelaz, A.R., Diefenbach, P., Simon, B. et al. Perceived Barriers to Weight Management in Primary Care—Perspectives of Patients and Providers. J GEN INTERN MED 22, 518–522 (2007). https://doi.org/10.1007/s11606-007-0125-4
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11606-007-0125-4