Views of Primary Care Physicians Regarding the Promotion of Healthy Lifestyles and Weight Management Among Their Patients

Finally, this study assessed physicians’ healthy lifestyle–related knowledge about current BMI ranges for adults and BMI percentile ranges for children, and recommended amounts of moderate physical activity and servings of fruits and vegetables for adults. Most physicians were able to correctly identify the adult BMI cutoff ranges for overweight and obesity and to identify the correct answers to questions about physical activity and fruits and vegetable consumption guidelines for adults. However, only 32% of physicians were able to correctly identify BMI percentile ranges for children and/or adolescents. This is understandable given that most of the physicians in this study provide care to adult patients. However, considering that in 2012 more than one-third of children and adolescents were overweight or obese [1], it is important that all physicians have knowledge of BMI percentile ranges for children and adolescents so that minimally they can convey this information to their adult patients who are parents. The USPSTF defines children and adolescent overweight as an age- and gender-specific BMI between the 85th and 94th percentiles, and children and adolescent obesity as an age- and gender-specific BMI ≥ 95th percentile [31]. Such knowledge of BMI cutoffs is needed in order for providers to comply with the USPSTF recommendation to screen all adults and children aged 6 years and older for obesity, and then offer or refer those with an obesity diagnosis to intensive multicomponent behavioral interventions [31–33].

While novel, the study also had several limitations. First, due to self-selection of participants, physicians who felt more confident in their abilities to address overweight or obesity with their patients might have been more likely to respond. Second, participating physicians may have given socially desirable responses to questions (ie, responses that present a favorable image of themselves) rather than true/accurate responses. Future studies could incorporate a social desirability scale in order to detect and control for any socially desirable responding [33]. Another limitation was the small sample size and the limited variability in geographic location of the participating physicians. Thus, the experiences of these physicians may not be generalizable to physicians in other geographic regions. Future similar studies to the present study are needed and such studies should use a larger and randomly selected sample of physicians that is racially/ethnically diverse. Finally, a limitation of this study is the 48% participation rate. Factors that may have contributed to this participation rate include lack of compensation for physicians and the likelihood that physicians may have extremely busy schedules that may discourage them from participating. However, it is important to note that the 48% participation rate of this study is better than the 25.6% participation rate in another similar study [25]. Future similar studies to the present study likely need to include strong incentives for physicians to be study participants.

Conclusion

Our study indicates that many primary care physicians may not talk with their patients about engaging in healthy eating, physical activity, and weight management because of perceived barriers that prevent them from doing so, rather than because of a lack of perceived responsibility to do so or a perception that counseling patients on these issues would be ineffective. This finding highlights the importance of providing physicians with the tools and resources needed to overcome the aforementioned barriers to fostering health-promoting lifestyles and a healthy weight among their patients and the importance of involving physicians in identifying these barriers and ways to overcome them.

Acknowledgement. We thank the patients and health care providers at the participating medical homes affiliated with University of Florida Health in Jacksonville, Florida, for making this research possible.

Corresponding author: Carolyn M. Tucker, PhD, University of Florida, cmtucker@ufl.edu.

Funding/support: Support for this research was provided by the Office of Research at UF–Gainesville, Florida, and by the National Institutes of Health and National Center for Research Resources CTSA grant UL1 TR000064.

Financial disclosures: None.