Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Obesity (Silver Spring). 2012 May;20(5):999-1005. doi: 10.1038/oby.2011.402. Epub 2012 Jan 19.
Using a national cross-sectional survey of 500 primary care physicians conducted between 9 February and 1 March 2011, the objective of this study was to assess the impact of physician BMI on obesity care, physician self-efficacy, perceptions of role-modeling weight-related health behaviors, and perceptions of patient trust in weight loss advice. We found that physicians with normal BMI were more likely to engage their obese patients in weight loss discussions as compared to overweight/obese physicians (30% vs. 18%, P = 0.010). Physicians with normal BMI had greater confidence in their ability to provide diet (53% vs. 37%, P = 0.002) and exercise counseling (56% vs. 38%, P = 0.001) to their obese patients. A higher percentage of normal BMI physicians believed that overweight/obese patients would be less likely to trust weight loss advice from overweight/obese doctors (80% vs. 69%, P = 0.02). Physicians in the normal BMI category were more likely to believe that physicians should model healthy weight-related behaviors-maintaining a healthy weight (72% vs. 56%, P = 0.002) and exercising regularly (73% vs. 57%, P = 0.001). The probability of a physician recording an obesity diagnosis (93% vs. 7%, P < 0.001) or initiating a weight loss conversation (89% vs. 11%, P ≤ 0.001) with their obese patients was higher when the physicians' perception of the patients' body weight met or exceeded their own personal body weight. These results suggest that more normal weight physicians provided recommended obesity care to their patients and felt confident doing so.
使用 2011 年 2 月 9 日至 3 月 1 日期间对 500 名初级保健医生进行的全国横断面调查，本研究旨在评估医生 BMI 对肥胖症治疗、医生自我效能、对榜样体重相关健康行为的看法以及对患者对减肥建议信任的影响。我们发现，与超重/肥胖医生相比，BMI 正常的医生更有可能与肥胖患者进行减肥讨论（30%比 18%，P = 0.010）。BMI 正常的医生对自己为肥胖患者提供饮食（53%比 37%，P = 0.002）和运动咨询（56%比 38%，P = 0.001）的能力更有信心。更高比例的 BMI 正常医生认为超重/肥胖患者不太可能信任超重/肥胖医生的减肥建议（80%比 69%，P = 0.02）。BMI 正常类别的医生更有可能认为医生应该树立健康的体重相关行为榜样——保持健康的体重（72%比 56%，P = 0.002）和定期锻炼（73%比 57%，P = 0.001）。当医生对患者体重的看法符合或超过其自身的个人体重时，医生记录肥胖诊断（93%比 7%，P <0.001）或与肥胖患者开始减肥对话（89%比 11%，P ≤0.001）的可能性更高。这些结果表明，更多正常体重的医生为其患者提供了推荐的肥胖症治疗，并对此充满信心。
