Physicians’ personal beliefs about weight-related care and their associations with care delivery: The U.S. National Survey of Energy Balance Related Care among Primary Care Physicians☆

Summary Background Overweight and obesity are major health risks in the United States (US) and primary care physicians (PCPs) are uniquely positioned to address them. However, their personal beliefs about weight-related care may influence their delivery of care. Methods A nationally representative sample of 2022 physicians completed the National Survey of Energy Balance-Related Care among Primary Care Physicians. Physicians responded to questions regarding their beliefs and clinical practices associated with weight control including assessment, counselling, referral and follow-up for diet, physical activity, and weight. Multivariate logistic regression was used to examine associations between physician characteristics and personal beliefs, and associations between personal beliefs and care delivery, adjusting for specialty, age, gender, race, region, urban/rural location, and patient population. Results Most physicians feel a responsibility (97%) to promote weight-related care, but over half (53%) have concerns about their effectiveness and almost two-thirds feel they lack effective strategies to help patients (63%). Demographics and medical specialty were associated with beliefs (female, Asian-American, Midwest and Southern location, and internal medicine physicians were more likely to have stronger positive beliefs about weight-related care). Personal beliefs about weight-related care were associated with the likelihood of its delivery. However, two practices, regular BMI assessment and referring patients for further evaluation and management, were less related to PCP beliefs than were other care practices. Conclusions PCPs' beliefs may be important to their practice of weight-related care. Training in behavioural counselling, and providing physician's tools and resources may help to address their concerns about helping patients with weight-related care.