Identification and management of overweight and obesity by internal medicine residents.

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> or =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.