A Narrative Review of Physician Perspectives Regarding the Social and Environmental Determinants of Obesity
- 262 Downloads
Purpose of Review
Diet-related chronic diseases result from individual and non-individual (social, environmental, and macro-level) factors. Recent health policy trends, such as population health management, encourage assessment of the individual and non-individual factors that cause these diseases. In this review, we evaluate the physician’s perspective on the individual and non-individual causes and management of obesity.
Physicians generally rated individual-level causes (i.e., biology, psychology, and behavior) as more important than social or environmental factors in the development of obesity, and utilized individual-level strategies over social or environmental strategies to manage obesity.
This review suggests that clinicians perceive individual characteristics to be more important in the development and management of obesity than social or environmental factors. Additional research is needed to understand why.
KeywordsObesity Etiology Management Attitude of health personnel Social determinants of health Environmental determinants of health
Monica Peek is funded through NIDDK P30 DK092949 as well as the Greenwall Foundation.
Compliance with Ethical Standards
Conflict of Interest
Ashley H. Noriea, Feenalie N. Patel, Debra A. Werner, and Monica E. Peek declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 2.Adult Obesity Facts [updated September 21, 2015; cited 2016 July 20]. 2015 Available from: http://www.cdc.gov/obesity/data/adult.html.
- 5.• Solar O, Irwin A. A conceptual framework for action on the social determinants of health. Social Determinants of Health Discussion Paper 2 (Policy and Practice). World Health Organization: Geneva, Switzerland, 2010. This article provides a framework for tackling social determinants of health. Google Scholar
- 6.National Heart, Lung, and Blood Institute. Managing overweight and obesity in adults: systematic evidence review from the Obesity Expert Panel, 2013. National Institutes of Health, 2013.Google Scholar
- 10.Pekka P, Pirjo P, Ulla U. Part III. Can we turn back the clock or modify the adverse dynamics? Programme and policy issues: influencing public nutrition for non-communicable disease prevention: from community intervention to national programme – experiences from Finland. Public Health Nutr. 2002;5:245–51.CrossRefPubMedGoogle Scholar
- 12.NHLBI Obesity Education Initiative Expert Panel. The practical guide: identification, evaluation, and treatment of overweight and obesity in adults. NIH Publication Number 00-4084. National Institutes of Health, National Heart, Lung, and Blood Institute, NHLBI Obesity Education Initiative, North American Association for the Study of Obesity: [Bethesda, Md.], 2000.Google Scholar
- 14.Summaries for patients. Treating obesity with drugs and surgery: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2005;142:I55.Google Scholar
- 16.National Institute for Health and Care Excellence. Obesity: Identification, Assessment and Management. 2014.Google Scholar
- 17.National Center for Health Statistics. Ambulatory Care Use and Physician office visits: Centers for Disease Control; 2017 [cited 2017 March 15]. Available from: https://www.cdc.gov/nchs/fastats/physician-visits.htm.
- 18.• Bleich SN, Gudzune KA, Bennett WL, Cooper LA. Do physician beliefs about causes of obesity translate into actionable issues on which physicians counsel their patients? Prev Med. 2013;56:326–8. This article shows that how physicians think about obesity affects how they manage it. CrossRefPubMedPubMedCentralGoogle Scholar
- 19.World Health Organization. What are social determinants of health? 2012 [cited 2017 March 15]. Available from: http://www.who.int/social_determinants/sdh_definition/en/.
- 21.• Tsai AG, Williamson DF, Glick HA. Direct medical cost of overweight and obesity in the USA: a quantitative systematic review. Obes Rev. 2011;12:50–61. This article synthesizes current literature to evaluate the financial burden of overweight and obesity in the US. CrossRefPubMedPubMedCentralGoogle Scholar
- 49.Medicare Program. Merit-based incentive payment system (MIPS) and alternative payment model (APM) incentive under the physician fee schedule, and criteria for physician-focused payment models. Final rule with comment period. Fed Regist. 2016;81:77008–831.Google Scholar
- 51.Institute of Medicine. Capturing Social and Behavioral Domains in Electronic Health Records: Phase, vol. 1. Washington: The National Academies Press; 2014.Google Scholar