Resident physician attitudes and competence about obesity treatment: need for improved education

Nichola J Davis, Himani Shishodia, Bizath Taqui, Claudia Dumfeh, Judith Wylie-Rosett, Nichola J Davis, Himani Shishodia, Bizath Taqui, Claudia Dumfeh, Judith Wylie-Rosett

Abstract

Background: Obesity is a common problem in primary care, but little is known about Internal Medicine residents' attitudes towards obesity treatment.

Objective: To describe resident attitudes about obesity treatment.

Methods: Cross-sectional survey of 101 Internal Medicine residents in Philadelphia, PA, and Bronx, NY. Responses to 18 items on a Likert scale assessed resident attitudes. Weight loss goals were assessed with open-ended questions to a clinical scenario. ANOVA with trend analysis compared questionnaire responses to resident postgraduate year (PGY) level. Associations between clinic site, PGY level, and dichotomized Likert responses were tested with chi-square analysis.

Results: 19% of residents felt competent in prescribing weight loss programs. Few residents (18%) considered the current recommendations of a 5-10% reduction in body weight to be successful in an obese hypothetical patient. Third-year residents reported greater feelings of negativity towards obese patients than first- and second year residents (p<.05)

Conclusions: Resident physicians do not feel competent in treating obesity and have unrealistic weight loss goals; third-year residents had more negative attitudes about obese patients compared to residents in their 1(st) or 2(nd) year of training. These areas are targets for further resident education about obesity management.

Keywords: obesity; resident education; treatment.

References

    1. Galuska DA, Will JC, Serdula MK, Ford ES. Are health care professionals advising obese patients to lose weight? JAMA. 1999;282:1576–1578.
    1. Foster GD, Wadden TA, Makris AP, et al. Primary care physicians’ attitudes about obesity and its treatment. Obes Res. 2003;11:1168–1177.
    1. Puhl RM, Brownell KD. Confronting and coping with weight stigma: an investigation of overweight and obese adults. Obesity (Silver Spring) 2006;14:1802–1815.
    1. Foster GD, Wadden TA, Makris AP, et al. Primary care physicians’ attitudes about obesity and its treatment. Obes Res. 2003;11:1168–1177.
    1. 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.
    1. National Institutes of Health. The Practical Guide Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. 2000.
    1. Block JP, DeSalvo KB, Fisher WP. Are physicians equipped to address the obesity epidemic? Knowledge and attitudes of internal medicine residents. Prev Med. 2003;36:669–675.
    1. Fabricatore A WTFG. Bias in Health Care Settings. In: Kelly D.Brownell., RMPMBSLR, editor. Weight Bias: Nature, Consequences and Remedies. New York: The Guilford Press; 2007. pp. 29–41.
    1. Gans KM, Ross E, Barner CW, Wylie-Rosett J, McMurray J, Eaton C. REAP and WAVE: new tools to rapidly assess/discuss nutrition with patients. J Nutr. 2003;133:556S–562S.
    1. Wing RR, Tate DF, Gorin AA, Raynor HA, Fava JL. A self-regulation program for maintenance of weight loss. N Engl J Med. 2006;355:1563–1571.
    1. Bodenheimer T, Wagner EH, Grumbach K. Improving primary care for patients with chronic illness: the chronic care model, Part 2. JAMA. 2002;288:1909–1914.
    1. Anderson C, Peterson CB, Fletcher L, Mitchell JE, Thuras P, Crow SJ. Weight loss and gender: an examination of physician attitudes. Obes Res. 2001;9:257–263.

Source: PubMed

3
Se inscrever