Pediatricians’ Own Weight: Self‐perception, Misclassification, and Ease of Counseling

Abstract

Pediatricians underdiagnose overweight and feel ineffective at counseling. Given the relationship between physicians' health and health habits and counseling behaviors, we sought to determine the 1) percentage of pediatricians who are overweight; 2) accuracy of pediatricians' own weight status classification; and 3) relationship between weight self-perception and perceived ease of obesity counseling. This study was a cross-sectional, mail survey of North Carolina pediatricians that queried about their weight status and ease of counseling. Accuracy of pediatricians' self-classification of weight status was compared with BMIs derived from self-reported height and weight. Using logistic regression, controlling for potential confounding variables, we examined the association between weight perception and ease of counseling. The unadjusted response rate was 62%, and the adjusted response rate was 71% (n = 355). Nearly one-half (49%) of overweight pediatricians did not identify themselves as such. Men had greater adjusted odds of misclassifying overweight than women [odds ratio (OR), 3.61; 95% confidence interval (CI) = 1.81, 7.21]. Self-classified "thin" pediatricians had nearly six times the odds of reporting more counseling difficulty as a result of their weight than "average" weight pediatricians (OR = 5.69; 95% CI = 2.30, 14.1), and self-identified "overweight" pediatricians reported nearly four times as great counseling difficulty as "average" weight physicians (OR = 3.84; 95% CI = 1.11, 13.3), after adjustment for self-reported BMI weight status and other potential confounders. The roles that physician weight misclassification and self-perception potentially play in influencing rates of obesity counseling warrant further research.