MUSC study finds physicians missing weight interventions

Heather Woolwine

Feb. 28, 2011

MUSC study finds physicians missing weight interventions

Overweight patients not always addressed about their weight issues

CHARLESTON -- No one likes to hear he is overweight. No one likes to tell someone else he is overweight. And certainly, use of the "F word" — FAT — has been deemed an insensitive way to describe the millions of Americans with weight issues. The result of these discomforts may be that the country's physicians are not doing enough to discuss weight issues with their patients.

An MUSC study by lead authors Robert Post, M.D., a former Family Medicine fellow, and Arch (Chip) Mainous, Ph.D., Family Medicine Professor, found that clinicians can be important influencers when trying to get overweight and obese patients to deal with their weight and related health issues. By counseling them to prevent further weight gain, clinicians can help patients to have a more realistic perception of their weight. Changing these perceptions is key to inducing beneficial behavioral changes, according to this report in the February 28th issue of Archives of Internal Medicine, one of the JAMA/Archives journals (Arch Intern Med. 2011;171[4]:316-321).

As many are aware, the increasing prevalence of overweight and obesity is a worldwide problem associated with higher risk of death, the development of certain cardiovascular diseases, type 2 diabetes, and some cancers. Recent evidence suggests that lifestyle interventions, including nutrition and physical activity components, are needed to maintain or lose weight, according to the authors. They suggest the primary care setting as suitable for such interventions, at least in the short term.

Post and his colleagues analyzed data from the 2005 - 2008 National Health and Nutrition Examination Survey (NHANES) on adults ages 20 to 64 years with a body mass index (BMI) of at least 25. The researchers were evaluating patient perceptions of overweight and obesity, and they also examined reports of physician acknowledgement of patients' weight status and whether that was associated with a difference in perceptions and behaviors, such as desire or attempts to lose weight.

"In participants with BMIs of 25 or greater, 45.2 percent reported that they had been told by their physician that they were overweight. In participants with BMIs of 30 or greater, 66.4 percent reported that they had been told by their physician that they were overweight," the authors said. "Telling an overweight patient that they are overweight was associated with a greater than eight-fold increase in the odds that the patient will classify themselves as overweight compared with a patient who has not been told they are overweight. For those who are obese, there was more than a six-fold increase." In addition, having been told that they were overweight or obese resulted in the participants having a greater desire to lose weight and, for some, attempting to lose weight.

The study authors concluded that patient reports of being told by a physician that one is overweight were associated with major increases in the odds that overweight and obese participants had realistic perceptions of their own weight, had a desire to lose weight, and had made recent attempts to lose weight. "However, fewer than one-half of overweight and fewer than two-thirds of obese participants had been told by their physicians that they are overweight. This is an important intervention point that is being missed by many physicians. Physicians need to tell more overweight and obese patients that they are overweight because this may help encourage them to change their behavior to lose weight and lower their risk for many diseases," the authors concluded.

About MUSC

Founded in 1824 in Charleston, The Medical University of South Carolina is the oldest medical school in the South. Today, MUSC continues the tradition of excellence in education, research, and patient care. MUSC educates and trains more than 3,000 students and residents, and has nearly 11,000 employees, including 1,500 faculty members. As the largest non-federal employer in Charleston, the university and its affiliates have collective annual budgets in excess of $1.7 billion. MUSC operates a 750-bed medical center, which includes a nationally recognized Children's Hospital, the Ashley River Tower (cardiovascular, digestive disease, and surgical oncology), and a leading Institute of Psychiatry. For more information on academic information or clinical services, visit or