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

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.