The DOI matches its Crossref record.
Barriers to Providing Nutrition Counseling by Physicians: A Survey of Primary Care Practitioners
Abstract
Background Previous surveys have shown that there is a disparity between physicians' beliefs about the importance of diet and nutrition in health maintenance and disease prevention and the actual delivery of nutrition counseling. The primary objective of this study was to assess the current attitudes, practice behavior, and barriers to the delivery of nutrition counseling by primary care physicians.Methods A random-sample-mailed questionnaire was sent to 2,250 primary care physicians selected from the AMA masterfile from general practice, internal medicine, and pediatrics, representing self-employed, group, hospital, and HMO practices. Participants were stratified by age, gender, geographical region, and present employment. The main outcome measures were to determine time spent by physicians providing and percentage of patients receiving dietary counseling and to identify barriers to the delivery of nutrition counseling.Results A 49% response rate (n = 1,103) was obtained. Results are presented for the 1,030 physicians (70% private practice) with complete data. Over two-thirds of physicians provide dietary counseling to 40% or less of patients and spend 5 or fewer min discussing dietary changes. Despite this pattern, nearly three-quarters of respondents feel that dietary counseling is important and is the responsibility of the physician. Ranking of perceived barriers to delivery of dietary counseling were lack of time, patient noncompliance, inadequate teaching materials, lack of counseling, training, lack of knowledge, inadequate reimbursement, and low physician confidence.Conclusions This survey suggests that multiple barriers exist that prevent the primary care practitioner from providing dietary counseling. A multifaceted approach will be needed to change physician counseling behavior.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“Given the demands on providers’ time, an increase in the frequency of PCP counseling does not appear to be feasible.8”
From A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice (2011) · cites this paper as [8]
Citations
Cited by
Sorted by citations
Items 301–400 of 607
Al-Doghether, M. H., Al-Tuwijri, A., & Khan, A. (2007) · Saudi Medical Journal · doi:10.15537/1658-3175.4025 · Cited by 16
State of the Art Reviews: Relationship Between Diet/ Physical Activity and Health
O’Neil, C. E., & Nicklas, T. A. (2007) · American Journal of Lifestyle Medicine · doi:10.1177/1559827607306433 · Cited by 16
Mogre, V., Scherpbier, A. J. J. A., Dornan, T., Stevens, F. C. J., Aryee, P. A., & Cherry, M. G. (2014) · Systematic Reviews · doi:10.1186/2046-4053-3-148 · Cited by 16
“There are several reasons for this, including lack of time and lack of confidence that patients will comply [1].”
BackgroundCross-sectional and longitudinal analyses of nutrition guidance by primary care physicians
Hiddink, G., Hautvast, J., van Woerkum, C., et al. (1999) · European Journal of Clinical Nutrition · doi:10.1038/sj.ejcn.1600800 · Cited by 16
Hartlieb, K. B., Engle, B., Obeso, V. T., et al. (2016) · MedEdPORTAL · doi:10.15766/mep_2374-8265.10455 · Cited by 16
Setting priorities for research in medical nutrition education: an international approach
Ball, L., Barnes, K. A., Laur, C. V., et al. (2016) · BMJ Open · doi:10.1136/bmjopen-2016-013241 · Cited by 16
Hewage, S. S., Singh, S. R., Chi, C., et al. (2018) · Clinical Diabetes · doi:10.2337/cd17-0063 · Cited by 16
“Participants shared that a lack of resources, increased patient loads, lack of proper reimbursement to PCPs based on the quality of care delivered, and inadequate technical training might hinder effective care by PCPs (17,23,25,26).”
BackgroundWalters, M. E., Dijkstra, A., de Winter, A. F., & Reijneveld, S. A. (2015) · BMC Health Services Research · doi:10.1186/s12913-015-0936-7 · Cited by 16
“An important determinant that arose in the interviews with the HHC workers and was also found in the literature was a lack of client interest in changing their behaviour [11, 27].”
BackgroundAnalysis of Nutrition Education in Osteopathic Medical Schools
Early, K. B., Adams, K. M., & Kohlmeier, M. (2015) · Journal of Biomedical Education · doi:10.1155/2015/376041 · Cited by 16
Barriers to Weight Loss Counseling
Briscoe, J. S., & Berry, J. A. (2009) · The Journal for Nurse Practitioners · doi:10.1016/j.nurpra.2008.08.018 · Cited by 16
Pediatric trainees’ engagement in the online nutrition curriculum: preliminary results
Lewis, K. O., Frank, G. R., Nagel, R. W., Turner, T. L., Ferrell, C. L., Sangvai, S. G., Donthi, R. R., & Mahan, J. D. (2014) · BMC Medical Education · doi:10.1186/1472-6920-14-190 · Cited by 16
“Background Despite the fact that nutrition plays a critical role in health promotion, disease prevention, and treatment of patients, many practicing physicians do not feel comfortable or adequately prepared to provide nutrition counseling related to the nutrition aspects of diseases or concerns of their patients [1,2].”
Treatment of Overweight and Obesity in Primary Care Practice: Current Evidence and Future Directions
Simkin‐Silverman, L. R., Conroy, M. B., & King, W. C. (2008) · American Journal of Lifestyle Medicine · doi:10.1177/1559827608317287 · Cited by 16
“Several studies suggest that physicians are skeptical of their patients’ commitment level for weight control.(15,45,47,56,57) For example, physicians report patient nonadherence,(45,56) patients’ lack of desire and ability to lose weight,(15) and patients’ unwillingness to take personal responsibility for their weight…”
BackgroundAconselhamento sobre modos saudáveis de vida na Atenção Primária e práticas alimentares dos usuários
de Andrade, K. A., de Toledo, M. T. T., Lopes, M. S., et al. (2012) · Revista da Escola de Enfermagem da USP · doi:10.1590/s0080-62342012000500012 · Cited by 16
Predictors of physicians’ practices related to nutritional counseling and management in Riyadh City
Al-Muammar, M. N. (2011) · Alexandria Journal of Medicine · doi:10.1016/j.ajme.2011.09.002 · Cited by 16
“This is in consistence to Kushner study (1995) who reported that nearly three quarters of respondents feel dietary counseling is important and is the responsibility of physicians.(9) Kolasa and Rickett(25) mentioned that the gap remains between the proportion of patients who physicians believe would benefit from nutri…”
BackgroundResultImplementing a Dietary Intervention in Primary Care Practice: A Process Evaluation
Lazovich, D., Curry, S. J., Beresford, S. A. A., Kristal, A. R., & Wagner, E. H. (2000) · American Journal of Health Promotion · doi:10.4278/0890-1171-15.2.118 · Cited by 16
Girgis, A., Sanson‐Fisher, R., & Walsh, R. A. (2001) · Preventive Medicine · doi:10.1006/pmed.2000.0781 · Cited by 15
Suresh, K., Holtrop, J. S., Dickinson, L. M., Willems, E., Smith, P. C., Gritz, R. M., & Perreault, L. (2022) · Trials · doi:10.1186/s13063-021-05954-7 · Cited by 17
“Health care providers cite lack of time, education, and resources, as well as competing issues, as the leading reasons why obesity is not prioritized [7–9], but poor reimbursement and lack of effective tools are also widely cited [7, 8].”
BackgroundMethodHowes, F., Warnecke, E., & Nelson, M. R. (2013) · Journal of Human Hypertension · doi:10.1038/jhh.2013.9 · Cited by 15
Strategies to enhance effectiveness of individual based nutrition communications
Kolasa, K. (2005) · European Journal of Clinical Nutrition · doi:10.1038/sj.ejcn.1602171 · Cited by 16
“Yet, virtually every published study on the issue shows that family physicians, although supportive, are not delivering nutrition services to their patients (Kushner, 1995; Soltesz et al, 1995a, b).”
BackgroundOh, R., Beresford, S. A. A., & Lafferty, W. E. (2006) · The Journal of the American Board of Family Medicine · doi:10.3122/jabfm.19.5.459 · Cited by 14
“38–40 In this study, the majority of physicians correctly answered that fish oil was effective in secondary prevention of CVD, but this knowledge was not independently associated with higher fish prescribing.”
The Effectiveness of Screening for Obesity in Primary Care: Weighing the Evidence
Wilson, A. R., & McAlpine, D. D. (2006) · Medical Care Research and Review · doi:10.1177/1077558706290942 · Cited by 15
“Reimbursement, limited office time, lack of training, and low confidence in ability to counsel (Kristeller and Hoerr 1997) or change behavior (Kushner 1995; Yeager et al. 1996) all have been cited as barriers to physician counseling.”
BackgroundStiegmann, R. A., Abreu, A., Gardner, J. E., Hipple, J. M., Poling, P. E., & Frates, E. P. (2017) · American Journal of Lifestyle Medicine · doi:10.1177/1559827617714782 · Cited by 14
“This is providing students a chance to think about LM in a practical way, while simultaneously allowing for community involvement in LM. Jessie M. Hipple—Pharmacy Student, Lipscomb University College of Pharmacy LMIG Faculty Adviser: Marni Hillinger, MD During my first year of pharmacy school, I started interning at t…”
BackgroundInfluentialMills, A. J., Kerschbaum, W. E., Richards, P. S., Czarnecki, G. A., Kinney, J. S., & Gwozdek, A. E. (2017) · PubMed · Cited by 14
Damali, U., Fredendall, L. D., Miller, J. L., Moore, D. D., & Dye, C. J. (2021) · Decision Sciences · doi:10.1111/deci.12514 · Cited by 13
Multimodal Telemonitoring for Weight Reduction in Patients With Sleep Apnea
Murase, K., Minami, T., Hamada, S., Gozal, D., Takahashi, N., Nakatsuka, Y., Takeyama, H., Tanizawa, K., Endo, D., Akahoshi, T., et al. (2022) · CHEST Journal · doi:10.1016/j.chest.2022.07.032 · Cited by 14
Visual Prompt Poster for Promoting Patient-Physician Conversations on Weight Loss
Stephens, G., Blanken, S. E., Greiner, K. A., et al. (2008) · The Annals of Family Medicine · doi:10.1370/afm.780 · Cited by 14
Nutritional training in gastroenterology
Harvey, J. A. H., & Neild, P. J. (2010) · Frontline Gastroenterology · doi:10.1136/fg.2009.000232 · Cited by 14
Effects of medical trainees’ weight‐loss history on perceptions of patients with obesity
Pearl, R. L., Argueso, D., & Wadden, T. A. (2017) · Medical Education · doi:10.1111/medu.13275 · Cited by 14
Somerville, M., Ball, L., Sierra‐Silvestre, E., & Williams, L. T. (2019) · Australian Journal of Primary Health · doi:10.1071/py19082 · Cited by 14
“Barriers to providing nutrition care by HCPs have been reported in the literature (Kushner 1995; Helman 1997; Moore et al. 2000) and was a common theme throughout this review.”
BackgroundResultHealth literacy needs in weight management of women with Polycystic Ovary Syndrome
Lim, S., Smith, C. A., Costello, M. F., MacMillan, F., Moran, L., Teede, H., & Ee, C. (2021) · Health Promotion Journal of Australia · doi:10.1002/hpja.349 · Cited by 14
Hearn, L., Miller, M., & CROSS, D. S. (2007) · Australian Journal of Primary Health · doi:10.1071/py07025 · Cited by 14
“, 2002), and few reported any confidence in their ability to change patient behaviour (Kushner, 1995).”
BackgroundPetrizzo, M. C., Block, L., Olvet, D. M., Sheridan, E. M., Dougherty, R., Whitson, M. J., John, J. T., Barilla-LaBarca, M.-L., Figlia-Peck, S. D., & Fornari, A. B. (2020) · Journal of the American College of Nutrition · doi:10.1080/07315724.2020.1737985 · Cited by 13
Tang, J. W., Freed, B. H., Baker, T., Kleczek, J., Tartaglia, K. M., Laiteerapong, N., Press, V. G., Schwartz, M., & Arora, V. M. (2009) · Journal of General Internal Medicine · doi:10.1007/s11606-009-1084-8 · Cited by 14
A personalized, multi-platform nutrition, exercise, and lifestyle coaching program: A pilot in women
Héroux, M., Watt, M., McGuire, K. A., & Berardi, J. (2016) · Internet Interventions · doi:10.1016/j.invent.2016.12.002 · Cited by 15
“…care providers often do not receive substantial training and support in weight management, often do not have sufficient clinic time to address a complex issue such as weight management, and perceive an inability to change patient behaviour (Jay et al., 2008; Kushner, 1995; Maheux et al., 1987).”
BackgroundReducing the prevalence of obesity in Canada: a call to action
Shentow-Bewsh, R., & Zuberi, D. M. (2018) · Social Work in Public Health · doi:10.1080/19371918.2018.1482252 · Cited by 13
“In another study of 1,103 American primary care doctors, participating physicians felt that nutrition counselling was one of their responsibilities to patients, yet the majority of them provided nutrition counselling to less than one half of their patients and only spent a few minutes doing so at any particular visit…”
BackgroundInfluentialThe Registered Dietitian in Primary Care: The Hamilton Experience
Gamblen, W. J., Schamehorn, S., Crustolo, A. M., et al. (2007) · Canadian Journal of Dietetic Practice and Research · doi:10.3148/68.2.2007.81 · Cited by 13
Feasibility of a mHealth Approach to Nutrition Counseling in an Appalachian State
Olfert, M. D., Barr, M. L., Hagedorn, R. L., Long, D. M., Haggerty, T. S., Weimer, M., Golden, J. H., Maurer, M. A., Cochran, J., Hendershot, T., et al. (2019) · Journal of Personalized Medicine · doi:10.3390/jpm9040050 · Cited by 12
“Healthcare providers in rural clinics have limited resources, increased workloads and longer hours when compared to their urban counterparts [19,20].”
BackgroundAn educational model for improving diet counselling in primary care
Olivarius, N. D. F., Palmvig, B., Andreasen, A. H., et al. (2004) · Patient Education and Counseling · doi:10.1016/j.pec.2004.08.013 · Cited by 13
“Primary care physicians’ most important perceived barriers to giving diet counselling are lack of time, lack of patient motivation to change dietary patterns, their own lack of knowledge about diet and especially lack of diet counselling training [2–4].”
BackgroundClinical nutrition in primary care: ESPEN position paper
Krznarić, Ž., Bender, D. V., Blaž, M. K., Cuerda, C., van Ginkel-Res, A., Hiesmayr, M., Marinho, A., Mendive, J. M., Monteiro, I., Pirlich, M., et al. (2024) · Clinical Nutrition · doi:10.1016/j.clnu.2024.02.017 · Cited by 12
Organization of Primary Care Practice for Providing Energy Balance Care
Klabunde, C. N., Clauser, S. B., Liu, B., Pronk, N. P., Ballard-Barbash, R. R., Huang, T. T. ‐., & Smith, A. W. (2013) · American Journal of Health Promotion · doi:10.4278/ajhp.121219-quan-626 · Cited by 12
Self-Reported Weight Loss Practices Among African American and Hispanic Adults in the United States
Burroughs, V. J., Nonas, C., Sweeney, C. T., Rohay, J. M., Harkins, A. M., Kyle, T. K., & Burton, S. L. (2010) · Journal of the National Medical Association · doi:10.1016/s0027-9684(15)30554-x · Cited by 12
Fuchs, K., Meusburger, D., Haldimann, M. L., & Ilic, A. (2019) · Biannual Conference of the Italian SIGCHI Chapter (CHItaly) · doi:10.1145/3351995.3352044 · Cited by 12
“sodium intake monitoring and behavior change interventions, which additionally often face the challenge of low recruitment and retention rates [49].”
BackgroundThe pediatric multidisciplinary obesity program: An update
Eneli, I., Cunningham, A., & Woolford, S. J. (2008) · Progress in Pediatric Cardiology · doi:10.1016/j.ppedcard.2008.05.011 · Cited by 13
“Yet, primary care providers are often reticent to diagnose and treat obesity, citing limited resources, inadequate knowledge and skills needed to counsel patients on weight loss, futility of available interventions, time constraints, and lack of reimbursement for obesity-related services [25–27].”
BackgroundBooth, A., Nowson, C. A., Huang, N., Lombard, C. B., & Singleton, K. L. (2006) · Public Health Nutrition · doi:10.1017/s1368980006009803 · Cited by 13
Overcoming Challenges to Obesity Counseling: Suggestions for the Primary Care Provider
Lewis, K. H., & Gudzune, K. A. (2014) · Journal of clinical outcomes management · Cited by 12
Gunsalus, K. T. W., Mixon, J. K., & House, E. M. (2024) · Medical Science Educator · doi:10.1007/s40670-024-02025-9 · Cited by 14
“However, the majority of physicians report receiving insufficient training to address their patients’ nutritional needs [36–41], despite 72–95% feeling that it is a physician’s responsibility to discuss nutrition with patients [36, 37, 40, 42].”
BackgroundA Novel Method of Increasing Medical Student Nutrition Awareness and Education
Schoettler, C. L., Lee, J. N., Ireland, K. A., & Lenders, C. M. (2015) · Journal of Biomedical Education · doi:10.1155/2015/784042 · Cited by 12
Learner-Directed Nutrition Content for Medical Schools to Meet LCME Standards
Hark, L. A., Deen, D., & Morrison, G. (2015) · Journal of Biomedical Education · doi:10.1155/2015/469351 · Cited by 11
“Practicing physicians also feel their nutrition training was inadequate and that they lack the skills to provide effective diet and lifestyle counseling to their patients [27–31].”
BackgroundPhysicians’ Knowledge of Clinical Nutrition Discipline in Riyadh Saudi Arabia
Aldubayan, K., Alsamani, A. S., Aladel, A., & Almuhtadi, Y. (2021) · Healthcare · doi:10.3390/healthcare9121721 · Cited by 11
“Several studies have stressed the importance of providing and including nutritional courses within medical school curricula [21,31,32].”
BackgroundNutritional care of elderly patients in acute care settings: A qualitative study
Gholizadeh, L., Yazdi, K., Nayeri, N. D., & Mohammadi, E. (2015) · Geriatrics and gerontology international/Geriatrics & gerontology international · doi:10.1111/ggi.12532 · Cited by 12
[OBESITY MANAGEMENT IN THE PRIMARY CARE SETTING BY AN INTENSIVE LIFESTYLE INTERVENTION].
Armenta-Guirado, B. I., Díaz-Zavala, R. G., Juillerat, M. E. V., & Plata, T. Q. (2015) · PubMed · doi:10.3305/nh.2015.32.4.9366 · Cited by 14
Maximizing your “nutrition minute”: Bridging nutritional gaps across the life span
Wright, W. L., & Zelman, K. M. (2018) · Journal of the American Association of Nurse Practitioners · doi:10.1097/jxx.0000000000000031 · Cited by 11
Keel, T., Olvet, D. M., Petrizzo, M. C., John, J. T., Dougherty, R., & Sheridan, E. M. (2021) · Nutrients · doi:10.3390/nu13114081 · Cited by 11
Schryver, T., & Smith, C. (2006) · Public Health Nutrition · doi:10.1017/phn2005920 · Cited by 11
An audit to assess awareness and knowledge of nutrition in a UK spinal cord injuries centre
Wong, S., Derry, F., Graham, A., et al. (2012) · Spinal Cord · doi:10.1038/sc.2011.180 · Cited by 11
Variations in physicians' advice for managing hypertension in women: A study using NHANES III
Martin, M. Y., Person, S. D., Shipp, M., Green, B. L., Crowther, M. R., & Lee, P. J. (2006) · Preventive Medicine · doi:10.1016/j.ypmed.2006.04.016 · Cited by 11
Hildebrand, C. A., Patel, M. B., Tenney, A. B., Logan, J. A., Luong, K. H., Crouch, M. J., Osta, A. E., DeRoo, C., Gilliland, K. O., Harlan, T. S., et al. (2024) · Teaching and Learning in Medicine · doi:10.1080/10401334.2024.2340977 · Cited by 15
“17,152 Culinary medicine training may help address some of these barriers.”
Ghosh, J., Gudzune, K. A., & Schwartz, J. L. (2025) · Obesity Pillars · doi:10.1016/j.obpill.2025.100161 · Cited by 11
Duijzer, G., Jansen, S., Haveman‐Nies, A., van Bruggen, R., ter Beek, J., Hiddink, G. J., & Feskens, E. J. M. (2012) · Family Practice · doi:10.1093/fampra/cmr096 · Cited by 10
Assessing the nutritional needs of men with prostate cancer
McLaughlin, K., Hedden, L., Pollock, P., Higano, C. S., & Murphy, R. A. (2019) · Nutrition Journal · doi:10.1186/s12937-019-0506-7 · Cited by 10
Safford, M. M., Cummings, D. M., Halladay, J. R., Shikany, J. M., Richman, J., Oparil, S., Hollenberg, J. P., Adams, A. D., Anabtawi, M., Andreae, L. J., et al. (2023) · Contemporary Clinical Trials · doi:10.1016/j.cct.2023.107183 · Cited by 10
Cole, K. O. W., & ROTER, D. L. (2016) · Patient Education and Counseling · doi:10.1016/j.pec.2016.05.002 · Cited by 10
Dietary and Behavioral Approaches in the Management of Obesity
Gudzune, K. A. (2016) · Gastroenterology Clinics of North America · doi:10.1016/j.gtc.2016.07.004 · Cited by 10
“Prior studies of physicians have often cited a lack of training or experience regarding weight management as a major barrier to counseling their patients.(8,9) Clinicians who did not receive adequate training on obesity might consider continuing medical education in this area if they plan to take a leading role in wei…”
Secondary Dyslipidemia In Obese Children - Is There Evidence For Pharmacological Treatment?
Radaelli, G., Sausen, G., Cesa, C. C., Portal, V. L., & Pellanda, L. C. (2018) · Arquivos Brasileiros de Cardiologia · doi:10.5935/abc.20180155 · Cited by 10
Daumit, G. L., Janssen, E. M., Jerome, G. J., Dalcin, A., Charleston, J. B., Clark, J. M., Coughlin, J. W., Yeh, H., Miller, E. R., Durkin, N., et al. (2019) · Translational Behavioral Medicine · doi:10.1093/tbm/iby120 · Cited by 9
“There are practical barriers such as primary care or other provider time, training, reimbursement, space needs, and identification of an effective weight loss approach [11].”
BackgroundBrief, effective experience to increase first-year medical students’ nutrition awareness
Coleman, M. T., Brantley, P. R., Wiseman, P., English, M. R., & Byerley, L. O. (2021) · Medical Education Online · doi:10.1080/10872981.2021.1896160 · Cited by 10
Connor, R., Cialdella-Kam, L. A., & Harris, S. R. (2015) · Journal of Biomedical Education · doi:10.1155/2015/181502 · Cited by 11
“The maximum amount of time that physicians usually spend on nutritional counseling is fiveminutes [8, 25].”
BackgroundNutrition advice provided by general practice registrars: an investigation using patient scenarios
Crowley, J., Ball, L., & Wall, C. R. (2016) · Public Health · doi:10.1016/j.puhe.2016.09.022 · Cited by 10
Pharmacologic treatment of obesity in adults: Standards of care in overweight and obesity
C, K. A. C. M. V. R. L. J. K. A. G. A. A. A. B. B. (2025) · BMJ Open Diabetes Research & Care · doi:10.1136/bmjdrc-2025-005729 · Cited by 18
“177 Given that in-depth nutritional counseling may be challenging in clinical practice, 178–180 referral to a registered dietitian nutritionist (RDN) for nutritional guidance should be considered for people prescribed obesity medications.”
Miller, M., Locke, A., Fuller, A. A., & Jensen, J. K. (2022) · American Journal of Lifestyle Medicine · doi:10.1177/15598276221120640 · Cited by 10
Defining the evolving field of culinary medicine across multiple domains
Hildebrand, C. A., Artz, K., Dollinger, B., Dotson, K., Dungan, D. D., Falquier, S. A., Faris, B., Fitzgerald, N., Guggenmos, K. J., Harlan, G. A., et al. (2025) · Frontiers in Nutrition · doi:10.3389/fnut.2025.1588449 · Cited by 12
Hicks, K. K., & Murano, P. S. (2016) · Social medicine · doi:10.71164/socialmedicine.v10i3.2016.878 · Cited by 9
“(Kushner, 1995) In 2014, Kris-Etherton and colleagues reported that physicians play key roles in the healthcare system both individually and as part of a team with other healthcare professionals.”
BackgroundHo, D. K. N., Nguyen, H. S., Irnandi, D. F., et al. (2021) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2021.09.003 · Cited by 9
Survey of Nutrition Education Among Medical Students
Duggan, M. P., Kodali, A., Panton, Z. A., Smith, S. M., Riew, G. J., Donaghue, J. F., Leya, G. A., & Briggs, L. G. (2023) · Journal of Wellness · doi:10.55504/2578-9333.1167 · Cited by 9
Wynn, K., Trudeau, J. D., Taunton, K., Gowans, M. C., & Scott, I. (2010) · Canadian Family Physician · Cited by 12
Behavioral and mental health risk factor profiles among diverse primary care patients
Glenn, B. A., Crespi, C. M., Rodríguez, H. P., Nonzee, N. J., Phillips, S. M., Gorin, S. S., Johnson, S. B., Fernández, M. E., Estabrooks, P. A., Kessler, R. S., et al. (2017) · Preventive Medicine · doi:10.1016/j.ypmed.2017.12.009 · Cited by 9
Arora, A., Poudel, P., Manohar, N., Bhole, S., & Baur, L. A. (2019) · Obesity Research & Clinical Practice · doi:10.1016/j.orcp.2019.03.005 · Cited by 9
Coppell, K. J., Freer, T., Abel, S. L., Whitehead, L., Tipene‐Leach, D., Gray, A. R., Merriman, T. R., Sullivan, T. A., Krebs, J. D., & Perreault, L. (2019) · BMJ Open · doi:10.1136/bmjopen-2019-033358 · Cited by 8
Lee, J. S., Wilson, A., Okunowo, O., Trinh, J., & Sivoravong, J. (2020) · American Journal of Lifestyle Medicine · doi:10.1177/1559827619896301 · Cited by 9
Student and faculty perceptions of nutrition education in medical school
Hawk, V., Kapounová, Z., Krobot, M., Spáčílová, V., Lagová, E., Podborská, M., & Haldeman, L. M. (2021) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2021.11.011 · Cited by 9
Priorities and Preferences for Weight Management and Cardiovascular Risk Reduction in Primary Care
Nemeth, L. S., Rice, L. J., Potts, M., et al. (2017) · Family & Community Health · doi:10.1097/fch.0000000000000155 · Cited by 9
Virtual Seminars for Medical Nutrition Education: Case Example
Kolasa, K. M., Daugherty, J. E., Jobe, A. C., et al. (2001) · Journal of Nutrition Education · doi:10.1016/s1499-4046(06)60357-6 · Cited by 9
Childhood obesity—a public health crisis
Mozlin, R. L. (2005) · Optometry · doi:10.1016/j.optm.2005.10.007 · Cited by 9
Interview Strategies Commonly Used by Pediatricians
Mendelsohn, J., Quinn, M. T., & McNabb, W. (1999) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpedi.153.2.154 · Cited by 9
A comparison of Dutch family doctors' and patients' perspectives on nutrition communication
van Dillen, S. M. E., & Hiddink, G. J. (2008) · Family Practice · doi:10.1093/fampra/cmn061 · Cited by 8
Torna, E., Fitzgerald, J. D., Nelson, D. S., & Andrade, J. (2021) · SN Comprehensive Clinical Medicine · doi:10.1007/s42399-020-00674-6 · Cited by 8
Outcome of patients consulting in an outpatient nutrition clinic for excessive body weight
Compe, A., Papoz, L., & Avignon, A. (2003) · Diabetes & Metabolism · doi:10.1016/s1262-3636(07)70066-6 · Cited by 8
“The reasons for this reluctance are varied, but include perceptions of the causes of obesity, lack of training, insufficient office time to deal with the difficulties patients face, limited staff support, and the perceived poor long-term success rate [3-9].”
BackgroundHayes, M., Wallace, J. P., & Coxon, A. (2016) · International Journal of Dental Hygiene · doi:10.1111/idh.12239 · Cited by 8
Nutrition, a Tenet of Lifestyle Medicine but Not Medicine?
Frame, L. A. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18115974 · Cited by 8
“Barnard and I would both argue that this is no longer acceptable even though the majority of clinicians report poor or no nutrition training [6,8,13,14]—61% in one survey of internal medicine residents [15].”
BackgroundHenderson, M., Daneman, D., Huot, C., McGrath, J. J., Lambert, M. A., Hux, J. E., Booth, G. L., & Hanley, A. J. (2010) · International Journal of Pediatric Endocrinology · doi:10.1155/2010/681510 · Cited by 8
“Moreover, physicians are sceptical of their ability to help patients change their behaviours [43, 44].”
BackgroundDeterminants of Dutch general practitioners’ nutrition and physical activity guidance practices
van Dillen, S. M. E., Hiddink, G. J., & van Woerkum, C. M. (2012) · Public Health Nutrition · doi:10.1017/s1368980012003564 · Cited by 8
Dutton, G. R., Lewis, C. E., Cherrington, A., Pisu, M., Richman, J., Turner, T., & Phillips, J. M. (2018) · Contemporary Clinical Trials · doi:10.1016/j.cct.2018.07.015 · Cited by 9
A survey on knowledge of nutrition of physicians in Bangladesh: evidence from Sylhet data
Uddin, M. T., Islam, N., & Uddin, M. J. (2008) · South-East Asian Journal of Medical Education · doi:10.4038/seajme.v2i2.478 · Cited by 8
“A study of physicians in USA found that many physicians would give dietary counseling to their patients (Kushner, 1995).”
BackgroundAl-Namash, H., Al-Najjar, A. A., Kandary, W. A., Makboul, G., & El-Shazly, M. K. (2011) · Alexandria Journal of Medicine · doi:10.1016/j.ajme.2011.01.004 · Cited by 7
“This may be due to lack of formal training of PCPs in nutrition, obesity, and counseling on weight-related topics, and perceived inability to change patient behaviors.(25) Several studies attribute this to lack of known effectiveness of treatments,(21,25) negative attitudes toward obese patients,(19,26,27) beliefs tha…”
BackgroundPavleković, G., & Brborović, O. (2005) · European Journal of Clinical Nutrition · doi:10.1038/sj.ejcn.1602173 · Cited by 8
“The most often cited barriers are lack of time, patient noncompliance, lack of patient interest, inadequate teaching materials, lack of counselling training, lack of nutritional knowledge, inadequate reimbursement and low physician confidence (Hiddink et al, 1995; Kushner, 1995).”
BackgroundMessage framing: A communication strategy for the medical encounter
Gray, J. B. (2008) · Journal of Communications In Healthcare · doi:10.1179/cih.2008.1.4.422 · Cited by 8
Lovell, S. A., & Neuwelt, P. M. (2011) · Journal of Primary Health Care · doi:10.1071/hc11041 · Cited by 8
Marrero, D. G. (2000) · Medical Care · doi:10.1097/00005650-200011000-00001 · Cited by 7
Pharmacologic Treatment of Obesity in Adults: Standards of Care in Overweight and Obesity
Gudzune, K. A., Apovian, C. M., Aroda, V. R., Aronne, L. J., Balapattabi, K., Bennett, A. K., ChallaSivaKanaka, S., ElSayed, N. A., Fitch, A., Fitzpatrick, S. L., et al. (2026) · Diabetes Obesity and Cardiometabolic CARE · doi:10.2337/doci25-0008 · Cited by 15
Self-citationvan Dillen, S. M. E., Noordman, J., van Dulmen, S., & Hiddink, G. J. (2015) · Public Health Nutrition · doi:10.1017/s1368980015000075 · Cited by 7
Metadata
- Authors
- Kushner, R. F.
- Affiliations
- University of Chicago (US)
- Corresponding author
- Kushner, R.F.
- ORCID
- Kushner, R.F.
- Venue
- Preventive Medicine
- Publisher
- Elsevier BV
- Published
- 1995-11
- Volume
- 24
- Issue
- 6
- Pages
- 546-552
- ISSN
- 0091-7435 (ISSN-L)
- OpenAlex
- W2007745104
- Cited by
- 604
- References
- 0
- Citations by year
- 2026: 9 · 2025: 14 · 2024: 17 · 2023: 19 · 2022: 18 · 2021: 21 · 2020: 15 · 2019: 29 · 2018: 25 · 2017: 27 · 2016: 34 · 2015: 33 · 2014: 27 · 2013: 28 · 2012: 29
- FWCI
- 7.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Preventive Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5p30dk026678-20)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK-26678)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Dietetics, Nutrition, and Education
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity and Health Practices
- Keywords
- nutrition counseling, primary care physicians, barriers to counseling, physician attitudes, physician practice behavior, time constraints, patient noncompliance, physician confidence, physician training, reimbursement, diet and health
- MeSH terms
- Adult, Counseling, Female, Humans, Health Knowledge, Attitudes, Practice, Male, Middle Aged, Physicians, Family, Surveys and Questionnaires, Time Factors, United States, Treatment Refusal, Workload, Nutritional Sciences
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
