Documentation and management of overweight and obesity in primary care

Abstract

Purpose: We examined overweight/obesity management in primary care in relation to body mass index (BMI), documentation of weight status, and comorbidities.

Methods: This analysis of baseline data from the Cholesterol Education and Research Trial included 2330 overweight and obese adult primary care patients from southeastern New England. Data were obtained via a telephone interview and abstraction of patients' medical records. BMI (kg/m(2)) was calculated from measured height and weight. Management of overweight/obesity included advice to lose weight, physical activity recommendations, dietary recommendations, and referral for nutrition counseling.

Results: Documentation of weight status was more common with increasing BMI (13% of overweight patients, 39% of mildly obese patients, and 77% of moderately/severely obese patients). Documentation of overweight/obesity was associated with increased behavioral treatment; the biggest increase was seen for advice to lose weight (odds ratios were 7.2 for overweight patients, 3.3 for patients with mild obesity, and 4.0 for patients with moderate/severe obesity). Although weight-related comorbidities were associated with increased overweight/obesity management at all BMIs, the biggest increase in odds was for patients with moderate/severe obesity.

Conclusions: Documentation of weight management was more common among patients with documented overweight/obesity and with weight-related comorbidities. These insights may help in designing new interventions in primary care settings for overweight and obese patients.

Figure 1

Management of overweight/obesity by documentation of overweight/obesity and degree of overweight/obesity The light grey bars represent patients without documented overweight/obesity and the dark grey bars represent patients with documented overweight/obesity.

Figure 2

Management of overweight/obesity by presence of at least one weight-related comorbidity and degree of overweight/obesity The light grey bars represent patients without selected weight-related comorbidities (diabetes, lipid disorders, hypertension, or cardiovascular disease) and the dark grey bars represent patients with at least one of these weight-related comorbidities.