Practice-related Factors in Primary Care May Limit Weight Management Services Offered

ObesityWeek® 2022

Primary care clinicians as a group report performing just 70% of a range of weight management services in their clinical practice, according to findings of a new survey. Factors associated with offering more services included "overall better practice culture" and a perception that the practice recognizes the importance of weight loss.

While the average weight management offerings trended low, however, the clinicians, from 18 primary health system practices in Colorado, appeared unanimous in wanting to learn more about effective clinical weight management, including food plan and workflow recommendations.

These results were presented at ObesityWeek® 2022, held in San Diego, CA, and virtually, November 1-4, 2022, along with other findings from the study which was designed to better understand the type of weight management services offered in primary care practice and what factors might be associated with providing more of the services.

First author Liegh Perreault, MD, associate professor of medicine, University of Colorado Anschutz Medical Camus, and colleagues surveyed primary care clinicians in 18 health system practices throughout Colorado to assess the amount and type of weight loss assistance offered to patients. Clinicians were presented with a list of 19 weight management services, eg, identifying obesity, educating patients, prescribing medications.

Responses were summarized using descriptive statistics. Then the investigators used linear regression with generalized estimating equations to assess associations between clinician characteristics and the amount of weight services provided.

Of the 397 surveys, the researchers received 257 for a response rate of 65%. Perreault et al found that, on average, clinicians reported performing 70% (IQR: 60%-80%) of the services listed. When the services were grouped into minimal, basic, and extensive types, the investigators report clinicians on average performed 87%, 78%, and 69% of them respectively.

Among the factors investigators found associated with performing more of the listed services were perception of “overall better practice culture (more team-ness, less chaos, more change culture)” and a perception of “weight management implementation climate (support for, recognition and expectation to support weight loss)," (p<.05).

Interestingly the research team reports that demographics, satisfaction with the practice’s provision of weight loss services, importance of providing weight management, and clinician-specific joy at work and level of burnout were not associated with the number of services performed.

Regardless of current level of services provided or perception of practice culture, 96% of the clinicians surveyed wanted to learn more about providing effective weight management services, including recommendations on diet and incorporating weight management services into practice workflow.

The authors conclude it may be worth further research into culture and implementation climate among other practice-associated factors to learn more about how to conduct effective weight management in primary care. They note that the data “add to the growing knowledge base about overcoming challenges to address obesity in the US.”

Abstract reference: Perreaul L, Kramer ES, Surehs K, et al. An assessment of weight loss management in health system primary system primary care practices. Abstract presented at ObesityWeek 2022; November 1-4, 2022; San Diego, CA.