Primary Care Physicians’ Attitudes about Obesity and Its Treatment

University of Alabama at Birmingham, Birmingham, Alabama, United States
Obesity research (Impact Factor: 4.95). 10/2003; 11(10):1168-77. DOI: 10.1038/oby.2003.161
Source: PubMed


This study was designed to assess physicians' attitudes toward obese patients and the causes and treatment of obesity.
A questionnaire assessed attitudes in 2 geographically representative national random samples of 5000 primary care physicians. In one sample (N = 2500), obesity was defined as a BMI of 30 to 40 kg/m(2), and in the other (N = 2500), obesity was defined as a BMI > 40.
Six hundred twenty physicians responded. They rated physical inactivity as significantly more important than any other cause of obesity (p < 0.0009). Two other behavioral factors-overeating and a high-fat diet-received the next highest mean ratings. More than 50% of physicians viewed obese patients as awkward, unattractive, ugly, and noncompliant. The treatment of obesity was rated as significantly less effective (p < 0.001) than therapies for 9 of 10 chronic conditions. Most respondents (75%), however, agreed with the consensus recommendations that a 10% reduction in weight is sufficient to improve obesity-related health complications and viewed a 14% weight loss (i.e., 78 +/- 5 kg from an initial weight of 91 kg) as an acceptable treatment outcome. More than one-half (54%) would spend more time working on weight management issues if their time was reimbursed appropriately.
Primary care physicians view obesity as largely a behavioral problem and share our broader society's negative stereotypes about the personal attributes of obese persons. Practitioners are realistic about treatment outcomes but view obesity treatment as less effective than treatment of most other chronic conditions.

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    • "This suggests that other factors than knowledge and education affect what advice the HCPs provided. Previous studies on attitude showed that attitude had greater impact on clinical practice than education21222324. In our study, many (80 %) HCPs felt hesitant towards LCD and this hesitancy was associated with perceived knowledge gaps. "

    Full-text · Article · Dec 2016
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    • "Ainsi les personnes obèses subissent une forte discrimination (Brownell et al., 2010 ; Puhl & Brownell, 2006 ; Puhl & Heuer, 2009), dans le milieu professionnel, par exemple (Puhl & King, 2013 ; Roehling, Roehling, & Pichler, 2007), où elles sont considérées comme moins compétentes que les personnes normo-pondérées (Lewis et al., 2011 ; Paraponaris, Saliba, & Ventelou, 2005), et où elles sont moins rémunérées (Brunello & D'Hombres, 2007 ; DeBeaumont, 2009), que les personnes normo-pondérées. Dans le milieu médical, elles sont parfois tenues pour responsables de leur corpulence et en sont blâmées (Foster et al., 2003 ; Keyworth, Peters, Chisholm, & Hart, 2012 ; Schwartz et al., 2003). Que ce soit dans le milieu médical (Avignon & Attalin, 2013 ; Puhl & Heuer, 2009 ; Schwartz et al., 2003 ; Teachman & Brownell, 2001), ou professionnel , on leur attribue des traits de caractère négatifs comme être paresseux, peu intelligent ou manquer de motivation (Teachman et al., 2003 ; Teachman & Brownell, 2001 ; Puhl & Brownell, 2001 ; Schwartz et al., 2003 ; De Brún, McCarthy, McKenzie, & McGloin, 2014). "

    Full-text · Dataset · Oct 2015
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    • "This may be especially problematic for overweight/obese patients with concomitant health problems as the quality of care they receive may suffer due to some medical professionals' preconceived notions about them. For example, some physicians report viewing obese patients as lazy and lacking in self-control and, as a result, consider it futile to attempt to assist patients with losing weight in an effort to manage other chronic medical conditions (Foster et al., 2003). Physicians also spend less time with obese patients, which, together with negative attitudes towards them, may translate into patient discomfort and less favorable diagnoses and treatment outcomes (Hebl et al., 2003). "
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    ABSTRACT: This study examined the association between attributing self-reported discrimination to weight and diabetes outcomes (glycemic control, diabetes-related distress, and diabetes self-care). A community dwelling sample of 185 adults (mean age 55.4; 80 % White/Caucasian 65 % female) with poorly controlled type 2 diabetes (HbA1c level ≥7.5 %) provided demographic and several self-report measures (including diabetes-related distress, diabetes self-care activities, discrimination, and attributions of discrimination), and had height, weight, and glycated hemoglobin (HbA1c) assessed by trained research staff as part of a larger research study. Individuals who attributed self-reported discrimination to weight had significantly higher HbA1c levels, higher levels of diabetes-related distress, and worse diabetes-related self-care behaviors (general diet, exercise, and glucose testing). These relationships persisted even when controlling for BMI, overall discrimination, depressive symptoms, and demographic characteristics. Results indicate that the perception of weight stigma among individuals with type 2 diabetes is strongly associated with a range of poor diabetes outcomes. Efforts to reduce exposure to and/or teach adaptive coping for weight stigma may benefit patients with type 2 diabetes.
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