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What is "obesity"--an analysis of referral letters to an obesity unit
Objectives:
To evaluate the quality of referral letters concerning obese patients from general practice and other specialities to an obesity unit.
Design:
Retrospective analysis of referral letters in 500 consecutive patient records.
Setting:
Academic specialist obesity unit.
Results:
Most letters came from general practice (70%), followed by internal medicine/endocrinology (12%). Information on body weight was missing in 13% of all referrals and on height in 24%. Waist circumference was mentioned in 1%. Relevant data substantiating possible comorbidities, in particular the metabolic syndrome, was missing in 92-97%. Relevant medication was indicated in 22% of the referrals. On a 3-point, graded global evaluation scale of the referral quality, only 7% of all letters were found to be 'ideal'.
Conclusion:
The low professional quality of these referrals may reflect the fact that physicians find the term 'obesity' enough to warrant the referral without further specifications. An alternative explanation for the inadequate referrals is the well documented negative attitude of physicians, who consider obesity as sloth and as a self-inflicted condition, not necessitating further medical details.