Wisconsin physician survey on diagnosis and treatment of obesity

Background: Obesity is an expensive and substantially undermanaged condition. The literature suggests that obesity is not always addressed and is infrequently documented in the patient’s problem list despite screening and interventional recommendations. Physician interest and referral has a positive effect on weight reduction strategies. Purpose: We conducted a cross-sectional email solicitation of Wisconsin physicians to complete a survey on their knowledge, perceptions and practices regarding obesity. Methods: Survey questions included obesity causes, definition, frequency, documentation and barriers to documentation, available consultation time, treatments used and barriers to treatment, and training in obesity management. From over 12,000 emails sent from the Wisconsin Medical Society, 590 responses were obtained. Results: Primary care physicians represented 61% of all respondents, and electronic medical records were used in 94% of their practices. Over 90% of respondents accurately identified obesity causes such as diet and activity level. Family support, depression, stress and lack of knowledge about nutrition were recognized as obesity causes by over 80% of respondents; 81% of respondents identified a body mass index of \u3e 30 as obese, and 71% of respondents correctly identified that 21-50% of the population is obese. Physicians reported documentation failure of obesity in the patient problem list for a variety of reasons, including treatment unavailability, lack of reimbursement, expense and lack of effectiveness. Failure to document was reported due to embarrassment discussing obesity by 19%, and 15% reported due to lack of pertinence to the visit. Time spent readdressing obesity in follow-up visits was 6 minutes or less for 77% of respondents. Referrals were most commonly made to dietitians and bariatric surgeons, but only 12% of respondents reported always or sometimes making referrals. Only 14% of respondents were optimistic about sustained weight loss, and only 7% believe they have been successful at treating obesity. Training in obesity management was reported to have occurred in 6% of medical school experiences and in 10% of respondent’s residency training. Conclusion: The effectiveness of physician obesity interventions must be improved. Training in obesity management during medical school and residency may improve patient outcomes. The majority of respondents stated they would be interested in receiving training in obesity management and reported lacking sufficient tools to assist in obesity management