Robinson Eric, Parretti Helen, Aveyard Paul
Institute of Psychology, Psychological Sciences, University of Liverpool, Liverpool.
Primary Care Clinical Sciences, University of Birmingham, Birmingham.
Br J Gen Pract. 2014 Nov;64(628):e703-8. doi: 10.3399/bjgp14X682285.
Guidelines suggest that GPs should intervene on patients' weight, but to do so GPs must first recognise that a patient may have a weight problem and weigh them.
To examine whether GPs and trainee GPs can identify overweight and obese body weights by sight, and if this influences whether they would discuss weight with a potential patient.
Study of GPs and trainee GPs on the lists of the UK NHS Workforce West Midlands Deanery and NHS Sandwell and West Birmingham Clinical Commissioning Group.
Participants viewed 15 standardised photographs of healthy-weight, overweight, and obese young males, and estimated their BMI, classified their weight status, and reported whether they would be likely to make a brief intervention for weight loss with that person.
The sample of GPs and trainee GPs correctly classified a mean of 4.0/5.0 of the healthy weight males, a mean of 2.4/5.0 of the overweight, and a mean of 1.7/5.0 of the obese males. For each 1 kg/m(2) increase in actual BMI, participants underestimated BMI by -0.21 (95% CI = -0.22 to -0.18), meaning that participants would underestimate the BMI of a man of 30 kg/m(2) by approximately 2.5 kg/m(2), but were more accurate for lower body weights. Participants were more likely to intervene with those with a higher estimated BMI (OR 1.53, 95% CI = 1.49 to 1.58).
This sample of predominantly trainee GPs perceived overweight and obese weights as being of lower BMI and weight status than they actually are, and this was associated with a lower intention of discussing weight management with a potential patient. This was found to be true for trainee and fully qualified GPs who participated in the study. Healthcare professionals should not rely on visual judgements when identifying patients who may benefit from weight management treatment.
指南建议全科医生应对患者的体重进行干预，但要做到这一点，全科医生必须首先认识到患者可能存在体重问题并为其称重。
研究全科医生和实习全科医生能否通过观察识别超重和肥胖体重，以及这是否会影响他们是否会与潜在患者讨论体重问题。
对英国国民健康服务体系西米德兰兹郡培训中心以及国民健康服务桑德韦尔和西伯明翰临床委托小组名单上的全科医生和实习全科医生进行研究。
参与者观看了15张健康体重、超重和肥胖年轻男性的标准化照片，估计他们的体重指数（BMI），对他们的体重状况进行分类，并报告他们是否可能会对该人进行简短的减肥干预。
全科医生和实习全科医生样本正确分类的健康体重男性平均为4.0/5.0，超重男性平均为2.4/5.0，肥胖男性平均为1.7/5.0。实际BMI每增加1kg/m²，参与者低估BMI的幅度为-0.21（95%置信区间=-0.22至-0.18），这意味着参与者会将BMI为30kg/m²的男性的BMI低估约2.5kg/m²，但对较低体重的判断更准确。参与者更有可能对估计BMI较高的人进行干预（比值比1.53，95%置信区间=1.49至1.58）。
这个主要由实习全科医生组成的样本认为超重和肥胖者的BMI和体重状况低于实际水平，这与与潜在患者讨论体重管理的意愿较低有关。研究发现，参与研究的实习全科医生和完全合格的全科医生都是如此。医疗保健专业人员在识别可能从体重管理治疗中受益的患者时，不应依赖视觉判断。
