Screening and management of obesity and perception of weight status in Medicaid recipients

We sought to identify any correlations among primary care provider weight screening and counseling, patient weight perception, and weight loss attempt.

We performed a cross-sectional analysis of obesity-related questions from 2009 and 2010 Kentucky Medicaid Adult Patient and Provider survey data.

1,510 patients [46% obese (body mass index (BMI) ≥30 kg/m2), 26% overweight (BMI 25 to <30), 26% normal weight (BMI 18 to <25), and 2% underweight (BMI<18)] and 787 providers (41% primary care) met criteria. Patients and providers differed on report of physician weight loss counseling (46% versus 92%). Patient report of physician weight loss counseling and weight loss attempt were positively correlated (77% with versus 38% without counseling, p<.01). One-fifth of patients underperceived their weight. Patients reporting physician weight counseling were less likely to underperceive their weight (13% versus 23%, p<.0001).

Weight loss attempt and accurate weight perception were positively correlated with physician weight discussion.