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November 6, 2002

Undertreatment of Obesity

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JAMA. 2002;288(17):2177. doi:10.1001/jama.288.17.2177-JMS1106-3-1

Despite the epidemiological data linking obesity to a number of medical diseases, there is evidence that physicians continue to underrecognize and undertreat it in the medical setting. For instance, although the first-line intervention for obesity is nutritional counseling, exercise, and recommendation of lifestyle changes, only 42% of obese US adults who had visited a primary care physician for a well-care visit in 1996 had been counseled about weight loss. Those patients who had been counseled by a physician and told specifically that they should lose weight were significantly more likely to report attempts at weight loss than those who were not.1 Although this study relied exclusively on self-reported data from patients, which could have confounded its results, other studies have come to similar conclusions using different methods. Analysis of the National Ambulatory Medical Care Surveys found that of 55 858 US adult physician office visits, behavioral counseling on specific weight reduction strategies such as dietary improvements and exercise regimens were individually provided to no more than a quarter of obese patients. Obesity itself was also underreported. Only 38% of patients classified as obese by height and weight were reported as obese by their physician.2