Trends in obesity-related counseling in primary care: 1995-2004

OBJECTIVE:: We sought to ascertain whether the percentage of visits in which physicians provided obesity-related counseling services increased between 1995 and 2004. METHOD:: Data came from the 1995 to 2004 National Ambulatory Medical Care Survey, an annual national survey of visits to office-based physicians. Analyses are restricted to visits by adults to a primary care physician (PCP; general/family or internal medicine). The main outcome measure is the percentage of visits to physicians where patients were counseled about exercise, diet/nutrition or weight loss. RESULTS:: Sample sizes ranged from 9,583 to 14,071. In 2003/2004, approximately 20% of visits to PCPs included counseling for diet/nutrition, 14% for exercise, and 6% for weight loss. Approximately 24% of visits included at least one of these types of counseling. The odds of receiving counseling for any of these services were 22% lower in 2001/2002 and 18% lower in 2003/2004 compared with 1995/1996. Patients who went to the doctor for weight-related concerns or with an obesity-related diagnosis were more likely to receive counseling than the general population. Longer visits were associated with greater probability of obesity-related counseling. CONCLUSIONS:: Obesity-related counseling does not appear to be a substantial part of the services provided by physicians. Further efforts in developing interventions that can be used by physicians and demonstrating their effectiveness within clinical practice are needed.