Nutrition-wise blog

Obesity: Doctors slow to address the problem

By Jennifer K. Nelson, R.D., L.D. and Katherine Zeratsky, R.D., L.D. April 2, 2010

Surprising findings about doctors' attitudes toward obesity were just released by the Strategies to Overcome and Prevent (STOP) Alliance for Obesity. A survey of primary care doctors revealed that:

  • Almost 90 percent of doctors feel it's their responsibility to help patients lose weight.
  • Yet 72 percent said that no one in their practice has been trained to deal with obesity and weight-related issues.

A separate survey of patients, including many who were obese (defined as body mass index of 30 or more), found that:

  • Only 39 percent of obese adults were ever told by a doctor or other health care provider that they were obese.
  • Of these 90 percent were told to lose weight, but one in three said they weren't given any guidance on how to do it.

Why the disconnect? The report suggests that the failure to address weight problems — so-called "clinical inertia" — may be caused by doctors' views on obesity (stigmatizing attitudes, belief that patient won't try), lack of confidence in their ability to treat obesity, lack of effective treatments and poor reimbursement for providing them.

What if "clinical inertia" existed for patients with diabetes or heart disease? (Obesity has been linked to these conditions.) Unthinkable, right?

The STOP Alliance for Obesity suggests several ways for doctors to start addressing the obesity epidemic:

  • Monitor weight over time. Don't lecture but explain how weight gain and obesity relate to risk for other diseases.
  • Assess motivation for change. Prescribe small lifestyle changes, such as eliminating sugary beverages. Suggest that these changes be a family affair.
  • Define success differently. Set more realistic goals, such as a weight loss of 5 to 10 percent of body weight.
  • Take a team approach. Enlist the help of others with expertise in weight loss — registered dietitians, exercise specialists, nurses and community programs.

Do you think these steps will be enough? Let's hear your suggestions.

- Jennifer

Apr. 02, 2010