Abstract
BackgroundThe worldwide increase in obesity is becoming a major health concern. General practitioners (GPs) play a central role in managing obesity. We aimed to examine Swiss GPs self-reported practice in diagnosis and treatment of obesity with a special focus on the performance of waist measurement.MethodsA structured self-reported questionnaire was mailed to 323 GPs recruited from four urban physician networks in Switzerland. Measures included professional experience, type of practice, obesity-related continuing medical education (CME) and practice in dealing with obesity such as waist measurement. We assessed the association between the performance of waist measurement and obesity-related CME by multivariate ordered logistic regression controlling for GP characteristics as potential confounders.ResultsA total of 187 GPs responded to the questionnaire. More than half of the GPs felt confident in managing obesity. The majority of the GPs (73%) spent less than 4 days in the last 5 years on obesity-related CME. More than half of GPs gave advice to reduce energy intakes (64%), intakes of high caloric and alcoholic drinks (56%) and to increase the physical activity (78%). Half of the GPs seldom performed waist measurement and documentation. The frequency of obesity-related CME was independently associated with the performance of waist measurement when controlled for GPs' characteristics by multivariate ordered logistic regression.ConclusionsThe majority of GPs followed guideline recommendations promoting physical activity and dietary counselling. We observed a gap between the increasing evidence for waist circumference assessment as an important measure in obesity management and actual clinical practice. Our data indicated that specific obesity-related CME might help to reduce this gap.
Highlights
The worldwide increase in obesity is becoming a major health concern
Full-time Part-time 50-90% Part-time 10-50% Work setting Working alone Working in group HMO Other No of patients < 100 100-150 > 150 Percentage of obese patients (BMI > 30 kg/m2) Percentage of obese patients getting a specific treatment Feel more confident in handling cardiovascular risk factors/obesity due to the membership in networks Yes Yes, a little No Nr. days attending obesity related continuing medical education (CME) < 1 day 1-3 days 4-10 days > 10 days
We confirmed that obesity is a prevalent problem in primary care and obesity related CME has the potential to improve General practitioners (GPs) behaviour in obesity management our study provides further evidence of the important role of GPs to control for the “obesity epidemic”
Summary
The worldwide increase in obesity is becoming a major health concern. General practitioners (GPs) play a central role in managing obesity. A national survey in U.S revealed that more than 65% of adult Americans are classified as either overweight or obese (body mass index [BMI] between 25 to ≥ 35) [5]. The results from recent Swiss Health Survey showed that overweight and obesity increased considerable in the last 15. Weight problems were generally determined by body mass index (BMI), but waist circumference could be a very useful and important indicator to identify those who are at risk and should seek weight management [7,8]. It has been shown that the waist circumference is a better predictor of obesity-related health risks such as the risk of metabolic syndrome, hypertension and dyslipidemia [1,6,7,9] than BMI
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