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Health care professionals lack knowledge of evidence-based obesity treatment
Health care providers have a limited understanding of evidence-based recommendations to address obesity, according to findings published in Obesity.
“Adults with obesity incur 42% higher medical costs per capita and are nearly two times more likely to die before age 70 than adults with a healthy weight,” Monique Turner, PhD, associate professor of prevention and community health and associate dean of MPH programs for The Milken Institute School of Public Health at George Washington University, and colleagues wrote in the study background. “Health care providers play a vital role in the prevention, treatment and control of obesity. Evidence suggests that multicomponent behavioral interventions, pharmacotherapy and bariatric surgery are all effective strategies that support clinically significant weight loss for persons with obesity. Yet application of these evidence-based treatments is uncommon.”
Turner and colleagues analyzed data from 1,506 health care providers who completed a web-based survey with questions designed to assess their knowledge of nonsurgical obesity treatment guidelines. Included in the sample were internists (n = 523), family practitioners (n = 480), obstetricians/gynecologists (n = 250) and nurse practitioners (n =253). Participants were randomly selected from SERMO’s Global Medical Panel and practice in the United States, see adult patients, and have been practicing for a minimum of 3 years. Researchers also controlled for demographic variables, including age, patient volume and practice setting.
Researchers found that provider type and years in practice affected health care provider understanding of clinical guidelines for pharmacotherapy, physical activity and behavioral counseling, with family practitioners providing the most responses that aligned with guidelines and internists selecting the least guideline-aligned responses.
Family practitioners demonstrated a better understanding of obesity counseling and pharmacotherapy guidelines vs. internists, nurse practitioners and obstetricians/gynecologists, according to researchers. After analyzing the results, researchers determined that health care providers were most knowledgeable about physical activity guidelines (49% correct), whereas health care providers demonstrated limited knowledge of evidence-based guidelines on the intensity of obesity counseling (15% correct).
“Unlike previous surveys, the questions used in this analysis were designed to assess [health care provider] knowledge of various evidence-based obesity treatment guidelines rather than their attitudes or behaviors,” the researchers wrote. “Because knowledge of obesity management is not routinely assessed by medical licensing exams, this analysis provides unique information on where knowledge is most lacking and how understanding of [intensive behavioral therapy] and pharmacotherapy guidelines differs for [family practitioners], internists, OB-GYNs and [nurse practitioners].”
Study limitations included no responses from several relevant provider types, including physician assistants.
“Our findings offer health professionals and medical educators a strong rationale for incorporating enhanced training on the prevention and management of obesity into their curricula,” William Dietz, MD, PhD, past president of The Obesity Society, director of the STOP Obesity Alliance and chair of the Sumner M. Redstone Global Center for Prevention and Wellness at the Milken Institute School of Public Health at George Washington University, said in a press release.
In a commentary on the research, Robert F. Kushner, MD, professor of medicine at Northwestern University Feinberg School of Medicine, clinical director of the Northwestern Comprehensive Center on Obesity, and director for the Center for Lifestyle Medicine in Chicago, wrote that the study’s primary outcome suggests that more obesity education is needed among health care providers.
“Knowledge of the guidelines is a reasonable objective, but is not sufficient to change practice behavior,” Kushner wrote. – by Melissa Webb
Disclosures: Dietz reports he receives personal fees from TI and serves on an advisory board for Weight Watchers. Another study author reports he receives personal fees from Eisai, Novo Nordisk, Orexigen and Rhythm. Kushner and Turner report no relevant financial disclosures.