Screening for obesity: clinical tools in evolution, a WREN study

Abstract

Background: The US Preventive Services Task Force (USPSTF) recommends that clinicians screen all adult patients for obesity and offer intensive counseling and behavioral interventions to promote sustained weight loss for obese adults. This recommendation acknowledges the absence of evidence for patient-oriented benefits (lower morbidity or mortality).

Objectives: We sought to determine temporal trends in clinician attitudes toward screening for obesity using body mass index (BMI) and other modalities, before and after introduction of an American Academy of Family Physicians (AAFP) obesity screening toolkit.

Methods: We performed 3 cross-sectional attitudinal surveys (2005-2007) of Wisconsin family physicians before and after they received the Americans In Motion - AIM to Change Toolkit.

Results: Response rates were 19.5% of 1429 in the 2005 survey, 21.7% of 1797 in the April 2007 survey, and 14.3% of 1580 in the December 2007 survey. Virtually all clinicians (98% -99%) reported in all 3 surveys that they routinely measured adult weight. There was a significant increase in reporting the routine measurement of adult height (from 57% to 74%) necessary for calculation of BMI. While most clinicians (91% in 2004 and 96% in 2007) agreed that it is important to screen all patients for obesity, there was less agreement that screening was feasible or effective.

Conclusions: While many Wisconsin family physicians endorse screening for obesity, fewer were convinced about screening's feasibility. We were unable to determine if the mailing of the AIM kit had a causal effect on the temporal trends observed.