Obesity Management in Primary Health Care: Front-Line Providers’ Experiences and Views

2020 
As in the rest of the world, obesity in Oman has increased and according to World Health Organization (WHO) data, prevalence of obesity in 2008 and 2016 were 20.9% and 27% respectively. This study explores primary care physicians’ current strategies and management of obesity, attitude and perceptions towards obesity, educational needs, and their views on long-term follow up. Methods: A cross sectional study was conducted where practicing family medicine physicians from different governorates were invited to participate in an online questionnaire-based survey. Participant were invited via email and responses were kept anonymous. Responses were collected over three weeks in April 2019 and only responses that met inclusion criteria were analyzed with SPSS v22. Results: 77 complete responses met inclusion criteria and female were the majority (67.5%). Half of participants had less than 10 years of experience. Weight and BMI were recorded routinely by two-thirds of participants whereas waist- hip ratio was recorded by only 12%. Weight reduction medications were prescribed by 5.2% and 24% would refer an obese patient to Bariatric center. Main barrier to obesity management and referral was inadequate obesity specialist centers followed by short consultation times. The pathophysiology mechanism of obesity and related hormones was only known by 40.8%. Almost all participants agreed that formal obesity management training should be integrated as part of residency training. Conclusion: Despite the significant number of comorbidities related to obesity and its complications, weight, BMI and other anthropometric measures were not routinely performed. Nationally, the rate of referral to bariatric centers for evaluation is low. Boundaries and challenges do exist and need to be addressed. Obesity and weight management need to be integrated as part of Family Physicians Training Program.
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