OBJECTIVE
To evaluate whether primary care physicians document obesity as a diagnosis and formulate
a management plan.
PATIENTS AND METHODS
The Mayo Clinic primary care database was used to identify general medical examinations
performed from November 1, 2004, to October 31, 2005, in a primary care clinic for
obese patients (body mass index [BMI] ≥30). Data on demographic variables, BMI, comorbidities,
documentation of obesity, and obesity management strategy were obtained through the
database. Multivariate logistic regression analyses were conducted to estimate multivariate
odds ratios (ORs) and 95% confidence intervals (CIs).
RESULTS
A total of 9827 patients were seen for a general medical examination. Of the 2543
obese patients, 505 (19.9%) had a diagnosis of obesity documented, and 574 (22.6%)
had an obesity management plan documented. Older patients (OR, 0.97 per year; 95%
CI, 0.96-0.98) and men (OR, 0.60; 95% CI, 0.47-0.76) were significantly less likely
to be diagnosed as having obesity, whereas those with a BMI greater than 35 (OR, 2.54;
95% CI, 2.10-3.16), diabetes mellitus (OR, 1.40; 95% CI, 1.09-1.78), and obstructive
sleep apnea (OR, 2.34; 95% CI, 1.79-3.07) were significantly more likely to have the
diagnosis made. Staff physicians were less likely than residents to document obesity
as a diagnosis (OR, 0.55; 95% CI, 0.44-0.69). Diagnosis of obesity was the strongest
predictor of formulation of an obesity plan (OR, 2.39; 95% CI, 1.90-3.02).
CONCLUSION
Most obese patients did not have a diagnosis of obesity or an obesity management plan
made by their primary care physician. Diagnosis of obesity results in a higher chance
of formulation of an obesity plan.
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Article Info
Footnotes
The abstract of this study was presented in part at the American College of Physicians Annual Session; Philadelphia, PA; April 6-8, 2006.
Identification
Copyright
© 2007 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
