The Impact of Obesity on Primary Care Visits

Authors

  • Klea D. Bertakis MD, MPH,

    1. Department of Family and Community Medicine, University of California, Davis, Sacramento, CA
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  • Rahman Azari

    Corresponding author
    1. Department of Statistics, University of California, Davis, Sacramento, CA
      University of California, Davis, Department of Family and Community Medicine, 4860 “Y” Street, Suite 2300, Sacramento, CA 95817. E-mail: kdbertakis@ucdavis.edu
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  • The costs of publication of this article were defrayed, in part, by the payment of page charges. This article must, therefore, be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

University of California, Davis, Department of Family and Community Medicine, 4860 “Y” Street, Suite 2300, Sacramento, CA 95817. E-mail: kdbertakis@ucdavis.edu

Abstract

Objective: To investigate the influence of patient obesity on primary care physician practice style.

Research Methods and Procedures: This was a randomized, prospective study of 509 patients assigned for care by 105 primary care resident physicians. Patient data collected included sociodemographic information, self-reported health status (Medical Outcomes Study Short Form-36), evaluation for depression (Beck Depression Index), and satisfaction. Height and weight were measured to calculate the BMI. Videotapes of the visits were analyzed using the Davis Observation Code (DOC).

Results: Regression equations were estimated relating obesity to visit length, each of the 20 individual DOC codes, and the six DOC Physician Practice Behavior Clusters, controlling for patient health status and sociodemographics. Obesity was not significantly associated with the length of the visit, but influenced what happened during the visit. Physicians spent less time educating obese patients about their health (p = 0.0062) and more time discussing exercise (p = 0.0075). Obesity was not related to discussions regarding nutrition. Physicians spent a greater portion of the visit on technical tasks when the patient was obese (p = 0.0528). Mean pre-visit general satisfaction for obese patients was significantly lower than for non-obese patients (p = 0.0069); however, there was no difference in post-visit patient satisfaction.

Discussion: Patient obesity impacts the medical visit. Further research can promote a greater understanding of the relationships between obese patients and their physicians.

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