From Department of Family and Community Health, Joan C. Edwards School of Medicine at Marshall University, Huntington, WV (DN, AH).
J Am Board Fam Med. 2018 Jul-Aug;31(4):522-528. doi: 10.3122/jabfm.2018.04.170467.
Obesity is a serious and highly prevalent health problem. Behavioral modification for weight loss is effective, and physician nutrition counseling is encouraged. Nevertheless, several studies have reported that physicians provide nutrition counseling infrequently. Time constraints and lack of patient compliance are among frequently reported barriers.
In this pilot study, we aimed to examine physician weight loss nutrition counseling among family physicians in Huntington, West Virginia, an area with the highest obesity prevalence in the United States.
We administered an anonymous 13-question online survey designed for this study to all area family physicians in continuity ambulatory practice, asking about how often they provided nutrition counseling to their comorbidly obese patients, their nutrition education background, the counseling resources used, and the barriers they faced.
Thirty-eight of the 47 invited physicians completed surveys. The 35 to 55 age group comprised 55% of the respondents. Men comprised 53% of our sample. Two-thirds of the physicians reported that they counseled at a high frequency. Twenty-six of the 38 physicians reported that their nutrition education in medical school was none to minimal. Of the rest, 47.2% viewed their education as clinically relevant. The most frequently-used specific patient education sources were those embedded in electronic health records, the US Department of Agriculture's MyPlate tool, and a variety of smartphone-based apps. Time constraints and lack of patient interest in nutrition topics were the leading barriers cited.
Family physicians practicing in the most obese population in the United States tend to be high-frequency obesity nutrition counselors who frequently use specific tools, consider their education lacking and face oft-cited barriers. Studies in other highly endemic areas are needed to confirm these findings.
肥胖是一个严重且普遍存在的健康问题。行为改变减肥法是有效的，鼓励医生进行营养咨询。然而，一些研究报告称，医生很少提供营养咨询。时间限制和患者不配合是经常被报道的障碍。
在这项试点研究中，我们旨在研究西弗吉尼亚州亨廷顿的家庭医生在减肥营养咨询方面的情况，该地区是美国肥胖率最高的地区。
我们对所有在连续门诊实践中的地区家庭医生进行了一项匿名的 13 个问题的在线调查，询问他们为并发肥胖患者提供营养咨询的频率、他们的营养教育背景、使用的咨询资源以及面临的障碍。
38 名受邀医生完成了调查。35 至 55 岁年龄组的受访者占 55%。我们的样本中男性占 53%。三分之二的医生报告说他们经常进行咨询。38 名医生中有 26 名报告说他们在医学院的营养教育为零到很少。其余的人中，47.2%认为他们的教育具有临床相关性。最常使用的特定患者教育资源是嵌入电子健康记录中的资源、美国农业部的“我的餐盘”工具和各种基于智能手机的应用程序。时间限制和患者对营养主题缺乏兴趣是被引用最多的主要障碍。
在美国肥胖人口最多的地区执业的家庭医生往往是高频肥胖营养咨询师，他们经常使用特定工具，认为自己的教育不足，并面临经常被引用的障碍。需要在其他高度流行地区进行研究来证实这些发现。
