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Documentation and Management of Overweight and Obesity in Primary Care

Center for Primary Care and Prevention, Memorial Hospital of Rhode Island, Pawtucket (MEW, MBR, DRP, CBE)
Department of Community Health (MEW, DRP, CBE), Warren Alpert Medical School, Brown University, Providence, RI
Department of Family Medicine (CBE), Warren Alpert Medical School, Brown University, Providence, RI

Correspondence: Corresponding author: Molly E. Waring, Center of Primary Care and Prevention, 2^nd floor, Memorial Hospital of Rhode Island, 111 Brewster Street, Pawtucket, RI 02860 (E-mail: molly_waring{at}brown.edu)

Purpose: We examined overweight/obesity management in primary care in relation to body mass index (BMI), documentation of weight status, and comorbidities.

Methods: This analysis of baseline data from the Cholesterol Education and Research Trial included 2330 overweight and obese adult primary care patients from southeastern New England. Data were obtained via a telephone interview and abstraction of patients’ medical records. BMI (kg/m²) was calculated from measured height and weight. Management of overweight/obesity included advice to lose weight, physical activity recommendations, dietary recommendations, and referral for nutrition counseling.

Results: Documentation of weight status was more common with increasing BMI (13% of overweight patients, 39% of mildly obese patients, and 77% of moderately/severely obese patients). Documentation of overweight/obesity was associated with increased behavioral treatment; the biggest increase was seen for advice to lose weight (odds ratios were 7.2 for overweight patients, 3.3 for patients with mild obesity, and 4.0 for patients with moderate/severe obesity). Although weight-related comorbidities were associated with increased overweight/obesity management at all BMIs, the biggest increase in odds was for patients with moderate/severe obesity.

Conclusions: Documentation of weight management was more common among patients with documented overweight/obesity and with weight-related comorbidities. These insights may help in designing new interventions in primary care settings for overweight and obese patients.

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