Document Detail


Speaking of weight: how patients and primary care clinicians initiate weight loss counseling.
MedLine Citation:
PMID:  15193904     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Obesity is epidemic in the US and other industrialized countries and contributes significantly to population morbidity and mortality. Primary care physicians see a substantial portion of the obese population, yet rarely counsel patients to lose weight. METHODS: Descriptive field notes of outpatient visits collected as part of a multimethod comparative case study were used to study patterns of physician-patient communication around weight control in 633 encounters in family practices in a Midwestern state. RESULTS: Sixty-eight percent of adults and 35% of children were overweight. Excess weight was mentioned in 17% of encounters with overweight patients, while weight loss counseling occurred with 11% of overweight adults and 8% of overweight children. In weight loss counseling encounters, patients formulated weight as a problem by making it a reason for visit or explicitly or implicitly asking for help with weight loss. Clinicians did so by framing weight as a medical problem in itself or as an exacerbating factor for another medical problem. CONCLUSIONS: Strategies that increase the likelihood of patients identifying weight as a problem, or that provide clinicians with a way to "medicalize" the patient's obesity, are likely to increase the frequency of weight loss counseling in primary care visits.
Authors:
John G Scott; Deborah Cohen; Barbara DiCicco-Bloom; A John Orzano; Patrice Gregory; Susan A Flocke; Lisa Maxwell; Benjamin Crabtree
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Preventive medicine     Volume:  38     ISSN:  0091-7435     ISO Abbreviation:  Prev Med     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-06-14     Completed Date:  2004-09-14     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0322116     Medline TA:  Prev Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  819-27     Citation Subset:  IM    
Affiliation:
Department of Family Medicine, Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, New Brunswick, NJ 08901, USA. scottjg@umdnj.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Counseling*
Diet
Exercise
Female
Humans
Infant
Male
Middle Aged
Obesity / therapy*
Physician-Patient Relations*
Weight Loss*
Grant Support
ID/Acronym/Agency:
HS09788/HS/AHRQ HHS; K07CA86046/CA/NCI NIH HHS; PE1011/PE/BHP HRSA HHS; R01HS08776/HS/AHRQ HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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