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	Institution: STANFORD Univ Med Center  | My Account | E-mail Alerts | Access Rights | Sign In Vol. 9 No. 7, July 2000   Archives  •  Online Features Original Contribution  This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (71)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal  Topic Collections  • Medical Practice  • Health Policy  • Obesity  • Alert me on articles by topic National Patterns of Physician Activities Related to Obesity Management Randall S. Stafford, MD, PhD; John H. Farhat, MPH; Bismruta Misra, MPH; David A. Schoenfeld, PhD Arch Fam Med. 2000;9:631-638. Context  National physician practices related to the clinical recognition and management of obesity are unknown. Objectives  To estimate national patterns of office-based, obesity-related practices and to determine the independent predictors of these practices. Design  Serial cross-sectional surveys of physician office visits. Setting  Ambulatory medical care in the United States. Patients  We analyzed 55,858 adult physician office visits sampled in the 1995-1996 National Ambulatory Medical Care Surveys. Data from the Third National Health and Nutrition Examination Surveys, 1988-1994 were used to assess and, then, adjust for the underreporting of obesity. Main Outcome Measures  Reporting of obesity at office visits and physician counseling for weight loss, exercise, and diet among patients identified as obese. Results  Physicians reported obesity in only 8.6% of 1995-1996 National Ambulatory Medical Care Surveys visits. The 22.7% prevalence rate of the Third National Health and Nutrition Examination Surveys, 1988-1994 suggests that physicians reported obesity in only 38% of their obese patients. Among visits by patients identified as obese, physicians frequently provided counseling for weight loss (35.5%), exercise (32.8%), and diet (41.5%). Adjusted for population prevalence; however, each service was provided to no more than one quarter of all obese patients. While patients with obesity-related comorbidities were treated more aggressively, in these patients, weight loss counseling occurred at only 52% of the visits. Conclusions  Specific interventions to address obesity are infrequent in visits to US physicians. Obesity is underreported and interventions are only moderately likely among patients identified as obese, even for those with serious obesity-related comorbidities. From the Institute for Health Policy, Massachusetts General Hospital, Harvard Medical School (Dr Stafford and Mr Farhat and Ms Misra) and the Biostatistics Center, Massachusetts General Hospital, Harvard Medical School, Harvard School of Public Health (Dr Schoenfeld), Boston. 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