Skip to main content
SpringerLink
Log in

Weight-related perceptions among patients and physicians

How well do physicians judge patients’ motivation to lose weight?

  • Original Articles
  • Published:
Journal of General Internal Medicine Aims and scope Submit manuscript

Abstract

BACKGROUND: Prior studies suggest that patients and physicians have different perceptions and expectations surrounding weight; however, few studies have directly compared patients’ and physicians’ perspectives.

OBJECTIVES: (1) To measure the extent to which obese patients and their physicians have discrepant weight-related perceptions, and (2) to explore patient and physician characteristics that may influence patient-physician discrepancy in motivation to lose weight.

DESIGN AND PARTICIPANTS: Four hundred and fifty-six obese patients (302 females; mean age =55.1 years; mean BMI =37.9) and their 28 primary care physicians (22 males, mean age =44.1 years) from nonmetropolitan practices completed an anonymous survey after an office visit.

MEASURES: Weight-related perceptions included perceived weight status, health impact of weight, 1-year weight loss expectations, and motivation to lose weight. Correlates included patient and physician sex, age, and BMI; physicians’ reported frequency, perceived patient preference, and confidence for weight counseling; and practice characteristics (e.g., years in practice).

RESULTS: Physicians assigned patients to heavier descriptive weight categories and reported a worse health impact than patients perceived for themselves, whereas patients believed they could lose more weight and reported a higher motivation to lose weight than their physicians perceived for patients (P <.001). Physicians who believed patients preferred to discuss weight more often (P=.001) and who saw more patients per week (P=.04) were less likely to underestimate patient motivation.

CONCLUSIONS: Patients reported more optimistic weight-related perceptions and expectations than their physicians. Further research is needed to determine how these patient-physician discrepancies may influence weight loss counseling in primary care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Strategic Plan for NIH Obesity Research: A Report of the NIH Obesity Research Task Force. In: Services USDoHaH, editor; 2004.

  2. Clinical guidelines on the identification, evaluation and treatment of overweight and obesity in adults: executive summary. Expert panel on the identification, evaluation, and treatment of overweight in adults. Am J Clin Nutr. 1998;68:899–917.

    Google Scholar 

  3. Serdula MK, Khan LK, Dietz WH. Weight loss counseling revisited. JAMA. 2003;289:1747–50.

    Article  PubMed  Google Scholar 

  4. Galuska DA, Will JC, Serdula MK, Ford ES. Are health care professionals advising obese patients to lose weight? JAMA. 1999;282:1576–8.

    Article  PubMed  CAS  Google Scholar 

  5. Sciamanna CN, Tate DF, Lang W, Wing RR. Who reports receiving advice to lose weight? Results from a multistate survey. Arch Intern Med. 2000;160:2334–9.

    Article  PubMed  CAS  Google Scholar 

  6. Stafford RS, Farhat JH, Misra B, Schoenfeld DA. National patterns of physician activities related to obesity management. Arch Fam Med. 2000;9:631–8.

    Article  PubMed  CAS  Google Scholar 

  7. Anis NA, Lee RE, Ellerbeck EF, Nazir N, Greiner KA, Ahluwalia JS. Direct observation of physician counseling on dietary habits and exercise: patient, physician, and office correlates. Prev Med. 2004;38:198–202.

    Article  PubMed  Google Scholar 

  8. Honda K. Factors underlying variation in receipt of physician advice on diet and exercise: applications of the behavioral model of health care utilization. Am J Health Promot. 2004;18:370–7.

    PubMed  Google Scholar 

  9. Wee CC, McCarthy EP, Davis RB, Phillips RS. Physician counseling about exercise. JAMA. 1999;282:1583–8.

    Article  PubMed  CAS  Google Scholar 

  10. Eberhardt MS, Pamuk ER. The importance of place of residence: examining health in rural and nonrural areas. Am J Public Health. 2004;94:1682–6.

    PubMed  Google Scholar 

  11. Patterson PD, Moore CG, Probst JC, Shinogle JA. Obesity and physical inactivity in rural America. J Rural Health. 2004;20:151–9.

    Article  PubMed  Google Scholar 

  12. Foster GD, Wadden TA, Makris AP, et al. Primary care physicians’ attitudes about obesity and its treatment. Obes Res. 2003;11:1168–77.

    PubMed  Google Scholar 

  13. Mercer S, Tessier S. A qualitative study of general practitioners’ and practice nurses’ attitudes to obesity management in primary care. Health Bull. 2001;59:248–53.

    CAS  Google Scholar 

  14. Kottke TE, Foels JK, Hill C, Choi T, Fenderson DA. Nutrition counseling in private practice: attitudes and activities of family physicians. Prev Med. 1984;13:219–25.

    Article  PubMed  CAS  Google Scholar 

  15. Kolagotla L, Adams W. Ambulatory management of childhood obesity. Obes Res. 2004;12:275–83.

    PubMed  Google Scholar 

  16. Story MT, Neumark-Stzainer DR, Sherwood NE, et al. Management of child and adolescent obesity: attitudes, barriers, skills, and training needs among health care professionals. Pediatrics. 2002;110 (Part 2):210–4.

    PubMed  Google Scholar 

  17. Jelalian E, Boergers J, Alday CS, Frank R. Survey of physician attitudes and practices related to pediatric obesity. Clin Pediatr (Philadelphia). 2003;42:235–45.

    Article  Google Scholar 

  18. Pratt C, Nosiri U, Pratt C. Michigan physicians’ perceptions of their role in managing obesity. Perceptual Motor Skills. 1997;84:848–50.

    CAS  Google Scholar 

  19. Truswell AS, Hiddink GJ, Hautvast JG. Family doctors and patients: is effective nutrition interaction possible? Eur J Clin Nutr. 1999;53(suppl 2):S1–2.

    Article  PubMed  Google Scholar 

  20. Wadden TA, Anderson DA, Foster GD, Bennett A, Steinberg C, Sarwer DB. Obese women’s perceptions of their physicians’ weight management attitudes and practices. Arch Fam Med. 2000;9:854–60.

    Article  PubMed  CAS  Google Scholar 

  21. Potter MB, Vu JD, Croughan-Minihane M. Weight management: what patients want from their primary care physicians. J Fam Pract. 2001;50:513–8.

    PubMed  CAS  Google Scholar 

  22. Foster GD, Phelan S, Wadden TA, Gill D, Ermold J, Didie E. Promoting more modest weight losses: a pilot study. Obes Res. 2004;12:1271–7.

    PubMed  Google Scholar 

  23. Foster GD, Wadden TA, Phelan S, Sarwer DB, Sanderson RS. Obese patients’ perceptions of treatment outcomes and the factors that influence them. Arch Intern Med. 2001;161:2133–9.

    Article  PubMed  CAS  Google Scholar 

  24. Foster GD, Wadden TA, Vogt RA, Brewer G. What is a reasonable weight loss? Patients’ expectations and evaluations of obesity treatment outcomes. J Consult Clin Psychol. 1997;65:79–85.

    Article  PubMed  CAS  Google Scholar 

  25. Serdula MK, Mokdad AH, Williamson DF, Galuska DA, Mendlein JM, Heath GW. Prevalence of attempting weight loss and strategies for controlling weight. JAMA. 1999;282:1353–8.

    Article  PubMed  CAS  Google Scholar 

  26. Miller WR, Rollnick S. Motivational Interviewing: Preparing People for Change. 2nd Ed. New York: Guilford Press; 2002.

    Google Scholar 

  27. Deci EL, Ryan RM. Intrinsic Motivation and Self-determination in Human Behavior. New York: Plenum; 1985.

    Google Scholar 

  28. Kolotkin RL, Crosby RD, Williams GR. Health-related quality of life varies among obese subgroups. Obes Res. 2002;10:748–56.

    PubMed  Google Scholar 

  29. Resnicow K, Kramish Campbell M, Carr C, et al. Body and soul; a dietary intervention conducted through African-American churches. Am J Prev Med. 2004;27:97–105.

    Article  PubMed  Google Scholar 

  30. Williams GC, Rodin GC, Ryan RM, Grolnick WS, Deci EL. Autonomous regulation and long-term medication adherence in adult outpatients. Health Psychol. 1998;17:269–76.

    Article  PubMed  CAS  Google Scholar 

  31. Carter-Nolan PL, Adams-Campbell LL, Williams J. Recruitment strategies for black women at risk for noninsulin-dependent diabetes mellitus into exercise protocols: a qualitative assessment. J Natl Med Assoc. 1996;88:558–62.

    PubMed  CAS  Google Scholar 

  32. Greiner KA, Engelman KK, Hall MA, Ellerbeck EF. Barriers to colorectal cancer screening in rural primary care. Prev Med. 2004;38:269–75.

    Article  PubMed  Google Scholar 

  33. Behavioral Risk Factor Surveillance System: Centers for Disease Control and Prevention: 1999.

  34. Resnicow K, Jackson A, Wang T, et al. A motivational interviewing intervention to increase fruit and vegetable intake through Black churches: results of the eat for life trial. Am J Public Health. 2001;91:1686–93.

    Article  PubMed  CAS  Google Scholar 

  35. Rollnick S, Butler CC, Stott N. Helping smokers make decisions: the enhancement of brief intervention for general medical practice. Patient Educ Couns. 1997;31:191–203.

    Article  PubMed  CAS  Google Scholar 

  36. Arab L, Carriquiry A, Steck-Scott S, Gaudet MM. Ethnic differences in the nutrient intake adequacy of premenopausal US women: results from the Third National Health Examination Survey. J Am Diet Assoc. 2003;103:1008–14.

    Article  PubMed  Google Scholar 

  37. Ellerbeck EF, Ahluwalia JS, Jolicoeur DG, Gladden J, Mosier MC. Direct observation of smoking cessation activities in primary care practice. J Fam Pract. 2001;50:688–93.

    PubMed  CAS  Google Scholar 

  38. Ellerbeck EF, Choi WS, McCarter K, Jolicoeur DG, Greiner A, Ahluwalia JS. Impact of patient characteristics on physician’s smoking cessation strategies. Prev Med. 2003;36:464–70.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Mail Stop 1008, 3901 Rainbow Boulevard, 66160, Kansas City, KS

    Christie A. Befort PhD, Sandra Hall PhD, Kim M. Pulvers MS, Nicole L. Nollen PhD & Andrea Charbonneau MD, MSc

  2. Department of Family Medicine, University of Kansas Medical Center, Kansas City, KS, USA

    K. Allen Greiner MD, MPH

  3. Center for Biostatistics and Advanced Informatics, University of Kansas Medical Center, Kansas City, KS, USA

    Sandra Hall PhD

  4. Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA

    Andrea Charbonneau MD, MSc

  5. Department of Pediatrics, University of Minnesota School of Medicine, Minneapolis, MN, USA

    Harsohena Kaur MD, MPH

  6. Department of Medicine and Office of Clinical Research, University of Minnesota School of Medicine, Minneapolis, MN, USA

    Jasjit S. Ahluwalia MD, MPH, MS

Authors
  1. Christie A. Befort PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. K. Allen Greiner MD, MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sandra Hall PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kim M. Pulvers MS
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Nicole L. Nollen PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Andrea Charbonneau MD, MSc
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Harsohena Kaur MD, MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Jasjit S. Ahluwalia MD, MPH, MS
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Christie A. Befort PhD.

Additional information

No conflicts of interest to report.

This project was supported by a grant from the Sunflower Foundation, Topeka, Kansas.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Befort, C.A., Greiner, K.A., Hall, S. et al. Weight-related perceptions among patients and physicians. J GEN INTERN MED 21, 1086–1090 (2006). https://doi.org/10.1111/j.1525-1497.2006.00567.x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1111/j.1525-1497.2006.00567.x

Key words

Search

Navigation