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Most American Doctors Failing Their Overweight and Obese Patients

By Christopher Cheney  
   May 16, 2019

For patients with no chronic conditions, only 20% of overweight patients and only 40% of obese patients receive lifestyle advice from clinicians.

American clinicians are missing opportunities to provide lifestyle advice to patients, recent research shows.

Chronic conditions afflict more than 130 million Americans—more than 40% of the population. Costs for chronic illness and mental health account for about 90% of the country's $3.3 trillion annual healthcare expenditures.

Clinicians are not providing adequate lifestyle advice about chronic disease, the recent research indicates.

"Prevalence of lifestyle modification advised by healthcare providers is generally low among U.S. adults with chronic conditions, and worryingly low among those without chronic conditions, however overweight or obese. Prescribed lifestyle modification is a missing opportunity in implementing sustainable strategies to reduce chronic condition burden," the researchers wrote.

The study examined federal data collected from more 11,000 adults for weight status and five chronic conditions—high blood pressure, high blood cholesterol, osteoarthritis, coronary heart disease, and diabetes.

The study generated several key data points:

  • High blood pressure (32.7%) and cholesterol (29.3%) were the most common chronic conditions compared with osteoarthritis (7.4%), diabetes (5.7%), and coronary heart disease (3.7%).
  • Diabetes patients received considerably more frequent advice (56.5%) than patients with high blood pressure (31.4%) and cholesterol (27.0%).
  • A "remarkably low" number of overweight (21.4%) and obese (44.2%) adults free of chronic conditions reported receiving any lifestyle advice.

"Our analyses revealed that about 20% of overweight and about 40% of obese adults received any lifestyle modification advice when free of chronic disease, demonstrating that most healthcare providers are missing this crucial primary prevention opportunity recommended by numerous guidelines," the researchers wrote.

Lifestyle advice included in the study was increased physical activity, reduced dietary fat and calories, and weight control.

Chronic disease management

A co-author of the study told HealthLeaders earlier research indicated that physicians require more knowledge in lifestyle medicine and behavior modification.

"This would mean more emphasis on these issues during medical school but also during residency training, preferably across all medical specialties. This is very important given the high and still rising prevalence of overweight and obesity in the U.S. population," said Sinisa Stefanac, MSc, of the Institute for Outcomes Research at the Medical University of Vienna in Austria.

Clinicians need more time to dispense advice, he said.

"Physicians need more time per patient in order to discuss these issues and need to have structural support by hospital or health center management that allows them the extra time to work with their patients. These changes are more structural and would take more time and understanding from political stakeholders."

Christopher Cheney is the senior clinical care​ editor at HealthLeaders.


More than 40% of the U.S. population has one or more chronic health conditions.

Recent research indicates overweight and obese adults are not receiving adequate lifestyle advice.

Clinicians need more time during office visits to dispense lifestyle advice.

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