Identification and management of overweight and obesity by internal medicine residents

Obesity is a major cause of morbidity and mortality in the United States.

To assess how frequently Internal Medicine residents identify and manage overweight and obese patients and to determine patient characteristics associated with identification and management of overweight compared with obesity.

A cross-sectional medical record review.

Four hundred and twenty-four overweight or obese primary care patients from 2 Internal Medicine resident clinics in Connecticut.

Measurements included the frequency with which obese and overweight patients were identified as such by their resident physicians, patient demographics, and co-morbid illnesses, as well as use of management strategies for excess weight.

In this population of obese and overweight patients, obese patients were identified and treated more often compared with overweight patients (76/246%, 30.9% vs 12/178%, 7.3% for identification, P=.001, and 59/246%, 24.0% vs 11/178%, 6.2% for treatment, P=.001). Overall, only 70/424 (17%) of patients received any form of management. Only higher body mass index (BMI) (BMI> or =30 kg/m2 compared with BMI 25-29.9 kg/m2) was independently associated with identification of overweight or obesity (odds ratio 7.51%, 95% confidence interval [CI] 3.76 to 15.02) or with any management for excess weight (odds ratio 4.79%, 95% CI 2.44 to 9.42).

Our results suggest that Internal Medicine residents markedly underrecognize and undertreat overweight and obesity.