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Cited by 54Obesity and Health PracticesObesity, Physical Activity, DietNutrition, Health and Food Behavior

What do physicians recommend to their overweight and obese patients?

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Phelan, S., Nallari, M., Darroch, F. E., Wing, R. R.·2009·The Journal of the American Board of Family Medicine
DOI 10.3122/jabfm.2009.02.080081
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Abstract

BACKGROUND: It is recognized that physicians play an important role in responding to the nation's obesity epidemic. Little is known, however, about what physicians say to their obese patients to help them lose weight. OBJECTIVE: This cross-sectional survey examined weight loss recommendations of family physicians and internists. Surveys were mailed to 188 physicians and 54% (n = 101) responded. The survey assessed physicians' weight loss recommendations, the basis for recommendations, and their expected weight loss outcomes for a hypothetical patient. Physicians rated the extent to which they recommended various weight control strategies to their obese patients. They also rated the extent to which clinical experience, personal experience, and the medical literature were important in formulating their recommendations. RESULTS: The most common strategies recommended were increasing physical activity, reducing consumption of fast foods, reducing portion sizes, and reducing soda consumption. Physicians were less likely to recommended regular self-weighing, recording food intake, and decreasing television viewing. Meal replacements and weight loss medications were rarely advised. Physicians reported that they based their weight loss recommendations more on clinical experience than on the medical literature or personal experience; these latter 2 were rated as equally important. Physicians reported that, from their perspective, the equivalent of a 21.5% weight loss would be an "acceptable" outcome for a hypothetical obese patient; a 10.6% weight loss "disappointing." CONCLUSIONS: Physicians, like patients, need to be educated about the benefits of modest weight loss and the weight loss strategies empirically proven to be most effective, including self-monitoring. Further research is needed to understand the barriers to recommending and implementing these effective strategies.

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  • In a survey of primary care physicians, acceptable behavioral weight loss was considered to be a loss of 21% of initial body weight.

    “Physician expectations are similarly inflated: in a survey of primary care physicians, acceptable behavioral weight loss was considered to be a loss of 21% of initial body weight83.”

    From Maintenance of Lost Weight and Long-Term Management of Obesity (2018) · cites this paper as [83]

    The Weight Loss Outcomes section reports that surveyed family physicians and internists considered about 21.5% weight loss acceptable for a hypothetical patient, calculated from the patient's initial weight. The Survey section does not specify behavioral treatment for that question, so the source supports the percentage but not the claim's behavioral-treatment qualifier. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • Both patients and healthcare providers have unrealistic expectations for weight loss outcomes.

    “Both patients and healthcare providers have wildly unrealistic expectations for weight loss outcomes.”

    From Maintenance of Lost Weight and Long-Term Management of Obesity (2018) · cites this paper as [83]

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2 of the 57 references couldn’t be matched to a known paper.

Research works printed but not linked: 6

  1. [11]11. Stafford RS, Rarhat JH, Misra B. National patterns 120 JABFM March-April 2009 Vol. 22 No. 2 http://www.jabfm.org on 24 August 2023 by guest. Protected by copyright. http://www.jabfm.org/ J Am Board Fam Med: first published as 10.3122/jabfm.2009.02.080081 on 5 March 2009. Downloaded from of physician activities related to obesity manage- ment. Arch Fam Med 2000;9:631-8.
  2. [12]12. Lyznicki JM, Young DC, Riggs JA, Davis RM. Obe- sity: assessment and management in primary care. Am Fam Physician 2001;63:2185-96.
  3. [15]15. Wadden TA, Andersen DA, Foster GD, Bennett A, Steinberg C, Sarwer DB. Obese women's percep- tions of their physician's weight management atti- tudes and practices. Arch Fam Med 2000;9:854 -60.
  4. [38]38. McAlpine DD, Wilson AR. Trends in obesity-re- lated counseling in primary care: 1995-2004. Med Care 2007;45:322-9.
  5. [43]43. Foster GD, Wadden TA, Phelan S, Sarwer DB, Sanderson RS. Obese patients' perceptions of treat- ment outcomes and the factors that influence them. Arch Intern Med 2001;161:2133-9.
  6. [49]49. McTigue KM, Harris R, Hemphill B, et al. Screen- ing and interventions for obesity in adults: summary of the evidence for the US Preventive Services Task Force. Ann Intern Med 2003;139:933-49.

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Authors
Phelan, S., Nallari, M., Darroch, F. E., & Wing, R. R.
Affiliations
  • California Polytechnic State University (US)
  • Montefiore Medical Center (US)
  • Miriam Hospital (US)
ORCID
Venue
The Journal of the American Board of Family Medicine
Publisher
American Board of Family Medicine (ABFM)
Published
2009-03-01
Volume
22
Issue
2
Pages
115-122
ISSN
  • 1557-2625 (ISSN-L)
  • 1558-7118
DOI
10.3122/jabfm.2009.02.080081
OpenAlex
W2125974928
Semantic Scholar
cf0498c8b99efdc801714289e1857651504b27c4
Cited by
54
References
57
Citations by year
2024: 1 · 2023: 2 · 2022: 1 · 2020: 2 · 2019: 7 · 2018: 3 · 2017: 5 · 2016: 2 · 2015: 4 · 2014: 6 · 2013: 3 · 2012: 5
FWCI
14.97
Type
journal article
Language
en
Open access
Locations
  • The Journal of the American Board of Family Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • DigitalCommons - CalPoly (California State Polytechnic University) (submittedVersion)
Topics
  • Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
Keywords
obesity, physician recommendations, general practitioners, internists, weight control strategies, physical activity, portion size reduction, self-monitoring, self-weighing, meal replacement, anti-obesity drugs, physician decision-making
MeSH terms
Adult, Counseling, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, New England, Obesity, Physician-Patient Relations, Health Care Surveys, Overweight

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