Effects of Education and Experience on Primary Care Providers' Perspectives of Obesity Treatments during a Pragmatic Trial
Open accessAbstract
Objective: To examine the impact of a 1‐year pragmatic obesity trial on primary care providers' (PCPs) perspectives of treatment. Methods: PCPs from four intervention clinics (PCP‐I) and five control clinics (PCP‐C) completed pre‐ and postintervention surveys on weight‐loss counseling, comfort discussing obesity treatments, and perceived effectiveness of interventions; questions were rated on 0 to 10 Likert scales. Only PCP‐I received patient updates and education about obesity management. Results: Eighty PCPs completed preintervention surveys (pre: 71% female, 71% physicians); 82 PCPs completed postintervention surveys (post: 66% female, 70% physicians). PCPs were most comfortable discussing exercise before and after the trial (pre PCP‐C: 8.22 [1.44], mean [standard deviation (SD)]; post PCP‐C: 8.37 [1.24]; P = 0.8; pre/post PCP‐I: 7.88 [1.51] vs. 7.80 [1.71]; P = 0.3). PCPs were initially least comfortable discussing phentermine/topiramate extended release (ER) but developed significantly more comfort after the trial, to a greater degree among PCP‐I (pre/post PCP‐C: 2.86 [2.66] vs. 3.73 [2.72], P < 0.001; pre/post PCP‐I: 4.00 [2.57] vs. 6.17 [2.27], P < 0.001). After the trial, both PCPs rated exercise significantly less effective for weight loss, with a greater decrease in effectiveness rations among PCP‐I (pre/post PCP‐C: 7.73 [1.94] vs. 6.93 [2.35], P = 0.017; pre/post PCP‐I: 6.27 [2.69] vs. 5.15 [2.31], P = 0.001). Both PCPs rated phentermine (pre/post PCP‐C: 5.03 [2.05] vs. 5.50 [2.12], P = 0.002; pre/post PCP‐I: 5.70 [1.64] vs. 6.83 [1.18], P = 0.001) and phentermine/topiramate ER (pre/post PCP‐C: 3.91 [2.33] vs. 5.47 [2.54], P < 0.001; pre/post PCP‐I: 5.58 [2.21] vs. 7.02 [1.47], P < 0.001) significantly more effective after the trial, though ratings were higher among PCP‐I. Conclusions: PCPs initially overvalued exercise and undervalued weight‐loss medications. PCPs exposed to education and experience gave higher comfort and effectiveness ratings to weight‐loss medications.
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Individuals with obesity but without diabetes are at elevated risk of developing diabetes and other cardiometabolic conditions compared with individuals without obesity.
“This subgroup, while sometimes characterized as metabolically healthy due to the lack of prevalent disease, is at elevated risk of developing diabetes and other cardiometabolic conditions compared with individuals without obesity.4,5,6,7”
From Factors Associated With Semaglutide Initiation Among Adults With Obesity (2025) · cites this paper as [7]
The Introduction states that obesity increases the risk of common chronic medical conditions, and its references include studies of diabetes incidence and incident hypertension (References; page not provided). The paper does not specifically assess people with obesity but without diabetes against people without obesity, so the claim’s subgroup comparison is not established by this source. (LLM, conf=0.82)
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- Authors
- Iwamoto, S., Saxon, D., Tsai, A., Leister, E., Speer, R., Heyn, H., Kealey, E., Juarez‐Colunga, E., Gudzune, K., Bleich, S., Clark, J., & Bessesen, D.
- Affiliations
- Denver VA Medical Center (US)
- VA Eastern Colorado Health Care System (US)
- Kaiser Permanente (US)
- Colorado School of Public Health (US)
- Denver Health Medical Center (US)
- University of Colorado Anschutz (US)
- Johns Hopkins University (US)
- Harvard University (US)
- Corresponding author
- Iwamoto, Sean
- ORCID
- Venue
- Obesity
- Publisher
- Wiley
- Published
- 2018-09-26
- Volume
- 26
- Issue
- 10
- Pages
- 1532-1538
- ISSN
- 1930-7381 (ISSN-L)
- 1930-739X
- PMC
- PMC6168402
- OpenAlex
- W2894215818
- Semantic Scholar
- 0e38d3c7e4642eed8cd89aa22194392883ff64f3
- Cited by
- 18
- References
- 47
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 1 · 2022: 2 · 2021: 4 · 2020: 2 · 2019: 3
- FWCI
- 4.43
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Obesity (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Patient-Centered Outcomes Research Institute (IH‐12‐11‐4571, P30 DK048520, T32 DK007446)
- National Institutes of Health (UL1 TR001082)
- Health Services Research and Development
- Topics
- Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- obesity treatment, primary care providers, weight loss counseling, exercise for weight loss, physician training, pragmatic trials, patient-provider communication
- MeSH terms
- Adult, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Obesity, Primary Health Care, Surveys and Questionnaires, Physicians, Primary Care
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