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Obese patients are treated differently during primary care visits

Nearly one in five Americans is obese, and while obesity does not appear to affect how much time a primary care doctor spends with a patient, it does affect what transpires during the visit. According to a study supported by the Agency for Healthcare Research and Quality (HS06167), primary care doctors spend less time educating obese patients about their health and more time discussing exercise, and conducting technical tasks such as history taking, doing medical exams, and performing in-office procedures.

University of California, Davis researchers Klea D. Bertakis, M.D., M.P.H., and Rahman Azari, Ph.D., studied videotapes of medical visits and the medical records of 509 patients cared for by 105 primary care resident physicians. They also administered questionnaires to the patients before and after medical visits.

A total of 205 patients were obese (body mass index scores of 30 or more), but only 37 percent of them were diagnosed as obese during the visit. Patient obesity, as well as poorer physical health, lower education, and lower income were significantly related to the physician spending more time on technical tasks. Physicians spent relatively less time during the initial medical encounter giving obese patients information about health, but spent more time educating patients with better health and higher economic status about health issues. The researchers suggest that physicians may choose not to address obesity because of time constraints, lack of confidence in their ability to treat obesity, or pessimism about a patient's ability to make necessary lifestyle changes.

See "The impact of obesity on primary care visits," by Drs. Bertakis and Azari, in the September 2005 Obesity Research 13(9), pp. 1615-1623.

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