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Brief report: Identification and management of overweight and obesity by internal medicine residents

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Abstract

BACKGROUND: Obesity is a major cause of morbidity and mortality in the United States.

OBJECTIVE: To assess how frequently Internal Medicine residents identify and manage overweight and obese patients and to determine patient characteristics associated with identification and management of overweight compared with obesity.

DESIGN: A cross-sectional medical record review.

PATIENTS: Four hundred and twenty-four overweight or obese primary care patients from 2 Internal Medicine resident clinics in Connecticut.

MEASUREMENTS: Measurements included the frequency with which obese and overweight patients were identified as such by their resident physicians, patient demographics, and co-morbid illnesses, as well as use of management strategies for excess weight.

RESULTS: In this population of obese and overweight patients, obese patients were identified and treated more often compared with overweight patients (76/246%, 30.9% vs 12/178%, 7.3% for identification, P=.001, and 59/246%, 24.0% vs 11/178%, 6.2% for treatment, P=.001). Overall, only 70/424 (17%) of patients received any form of management. Only higher body mass index (BMI) (BMI ≥30 kg/m2 compared with BMI 25–29.9 kg/m2) was independently associated with identification of overweight or obesity (odds ratio 7.51%, 95% confidence interval [CI] 3.76 to 15.02] or with any management for excess weight (odds ratio 4.79%, 95% CI 2.44 to 9.42).

CONCLUSIONS: Our results suggest that Internal Medicine residents markedly underrecognize and undertreat overweight and obesity.

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Authors and Affiliations

  1. Department of Medicine, Veterans Affairs Connecticut Healthcare System, West Haven, Conn, USA

    Christopher B. Ruser MD, Gina R. Brescia MD & Dawn M. Bravata MD

  2. Department of Medicine, Yale University Medical School, New Haven, Conn, USA

    Christopher B. Ruser MD, Lisa Sanders MD, Gina R. Brescia MD, Meredith Talbot MD & Dawn M. Bravata MD

  3. Department of Medicine, Waterbury Hospital, Waterbury, Conn, USA

    Karl Hartman MD

  4. Department of Medicine, University of California, San Diego, Calif, USA

    Kathleen Vivieros MD

  5. Clinical Epidemiology Research Center, Veterans Affairs Connecticut Healthcare System, Conn, USA

    Dawn M. Bravata MD

Authors
  1. Christopher B. Ruser MD
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  2. Lisa Sanders MD
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  3. Gina R. Brescia MD
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  4. Meredith Talbot MD
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  5. Karl Hartman MD
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  6. Kathleen Vivieros MD
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  7. Dawn M. Bravata MD
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Corresponding author

Correspondence to Christopher B. Ruser MD.

Additional information

None of the authors have a potential conflict of interest to report.

Funding: Dr. Dawn Bravata is supported by a Career Development Award from the Veterans Affairs Health Services Research & Development Service.

Author’s Contributions: Drs. Ruser and Sanders conceived of the study. Drs. Ruser, Sanders, and Bravata designed the study. Drs. Ruser, Sanders, Brescia, Talbot, Hartman, and Vivieros conducted the data collection. Drs. Ruser, Sanders, and Bravata were primarily responsible for drafting and revising the manuscript.

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Ruser, C.B., Sanders, L., Brescia, G.R. et al. Brief report: Identification and management of overweight and obesity by internal medicine residents. J GEN INTERN MED 20, 1139–1141 (2005). https://doi.org/10.1111/j.1525-1497.2005.0263.x

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  • DOI: https://doi.org/10.1111/j.1525-1497.2005.0263.x

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