Table 4

Beliefs about Obesity and Weight Loss, Barriers to Care, and Usefulness of Additional Weight Management Services

Mean (sd)1

n (%)


    Provider Level Barriers

Most obese patients are not ready to do anything about their weight

3.1 (0.9)

0

Strongly Disagree

16 (29.1)

Disagree

21 (38.2)

Neutral

14 (25.5)

Agree

4 (7.3)

Strongly Agree

There is no evidence that physician-deliveredweight management counseling is effective

2.5 (0.8)

5 (9.1)

Strongly Disagree

25 (45.5)

Disagree

20 (36.4)

Neutral

5 (9.1)

Agree

0

Strongly Agree

There are no effective treatments for obesity

2.1 (0.8)

8 (14.5)

Strongly Disagree

38 (69.1)

Disagree

6 (10.9)

Neutral

2 (3.6)

Agree

1 (1.8)

Strongly Agree

I learned good obesity management practices in medical school

2.8 (1.0)

5 (9.1)

Strongly Disagree

17 (30.9)

Disagree

20 (36.4)

Neutral

12 (21.8)

Agree

1 (1.8)

Strongly Agree

I learned good obesity management practices during residency training

2.9 (1.0)

5 (9.1)

Strongly Disagree

15 (27.3)

Disagree

18 (32.7)

Neutral

15 (27.3)

Agree

2 (3.6)

Strongly Agree

I sometimes do not address obesity in fear of "ruining the relationship"

2.0 (0.8)

14 (25.5)

Strongly Disagree

29 (52.7)

Disagree

8 (14.5)

Neutral

4 (7.3) 0

Agree Strongly Agree

    System-Level Barriers

I need more education about weight management services offered by the VA

4.1 (0.5)

0

Strongly Disagree

0

Disagree

3 (5.6)

Neutral

41 (75.9)

Agree

10 (18.5)

Strongly Agree

The VA needs more comprehensive weight management services

3.9 (0.6)

0

Strongly Disagree

2 (3.6)

Disagree

7 (12.7)

Neutral

39 (70.9)

Agree

7 (12.7)

Strongly Agree

The VA needs to make obesity a higher priority

3.8 (0.8)

0

Strongly Disagree

4 (7.3)

Disagree

9 (16.4)

Neutral

35 (63.6)

Agree

7 (12.7)

Strongly Agree

I would be more likely to address obesity with patients if visit times were longer

3.5 (1.0)

3 (5.5)

Strongly Disagree

6 (10.9)

Disagree

12 (21.8)

Neutral

28 (50.9)

Agree

6 (10.9)

Strongly Agree

Lack of payment by insurers hinders my weight management practices in VA primary care

2.8 (1.0)

5 (9.1)

Strongly

16 (29.1)

Disagree

19 (34.5)

Neutral

19 (27.3)

Agree

0

Strongly Agree

    Beliefs about Obesity and Weight Loss

Obesity is a very important public health problem

4.8 (0.5)

0

Strongly Disagree

0

Disagree

1 (1.8)

Neutral

9 (16.4)

Agree

45 (81.8)

Strongly Agree

Obesity is difficult to treat

4.4 (0.6)

0

Strongly Disagree

0

Disagree

2 (3.6)

Neutral

27 (49.1)

Agree

26 (47.3)

Strongly Agree

Obesity is a disease

4.2 (0.9)

1 (1.8)

Strongly Disagree

1 (1.8)

Disagree

6 (10.9)

Neutral

23 (41.8)

Agree

24 (43.6)

Strongly Agree

I am more likely to address obesity if the patient is younger

3.0 (1.0)

1 (1.8)

Strongly Disagree

22 (40.0)

Disagree

14 (25.5)

Neutral

15 (27.3)

Agree

3 (5.5)

Strongly Agree

Most VA patients attribute their obesity to an external cause (e.g., agent orange) rather than an internal cause (e.g., their lack of self discipline

2.6 (0.8)

1 (1.8)

Strongly Disagree

27 (49.1)

Disagree

19 (34.5)

Neutral

5 (9.1)

Agree

2 (3.6)

Strongly Agree

Having multiple comorbidities (e.g., diabetes, hypertension, osteoarthritis) makes it less likely that I will address obesity

1.9 (1.1)

26 (47.3)

Strongly Disagree

19 (34.5)

Disagree

3 (5.5)

Neutral

6 (10.9)

Agree

1 (1.8)

Strongly Agree

    Usefulness of Additional Services

The VA needs to develop educational materials about weight management to pass out to patients

4.1 (0.6)

0

Strongly Disagree

1 (1.8)

Disagree

4 (7.3)

Neutral

39 (70.9)

Agree

11 (20.0)

Strongly Agree

Having an obesity educator in the VA would be helpful

4.1 (0.8)

1 (1.8)

Strongly Disagree

1 (1.8) 5 (9.1)

Disagree Neutral

33 (60.0)

Agree

15 (27.3)

Strongly Agree

Having a referral box for a dietician on CPRS would be helpful

4.0 (0.8)

2 (3.6)

Strongly Disagree

0

Disagree

6 (10.9)

Neutral

38 (69.1)

Agree

9 (16.4)

Strongly Agree

Having a referral box for a physical therapist on CPRS would be helpful

3.9 (0.8)

2 (3.6)

Strongly Disagree

0

Disagree

8 (14.5)

Neutral

39 (70.9)

Agree

6 (10.9)

Strongly Agree

Having a referral box for a behavioral counselor on CPRS would be helpful

3.9 (0.8)

2 (3.6)

Strongly Disagree

1 (1.8)

Disagree

6 (10.9)

Neutral

39 (70.9)

Agree

7 (12.7)

Strongly Agree

Group appointments for obesity (e.g., nutrition class, exercise class, behavior change class) would be helpful

3.9 (0.9)

1 (1.8)

Strongly Disagree

4 (7.3)

Disagree

10 (18.2)

Neutral

26 (47.3)

Agree

14 (25.5)

Strongly Agree

Having patients fill out a readiness to change questionnaire about obesity prior to the visit would be helpful

3.7 (0.9)

2 (3.6)

Strongly Disagree

3 (5.5)

Disagree

10 (18.2)

Neutral

35 (63.6)

Agree

5 (9.1)

Strongly Agree

The VA should give monetary incentives for weight loss (e.g. cash, reduction of copays, free obesity-related services)

3.1 (1.3)

8 (14.8)

Strongly Disagree

12 (22.2)

Disagree

10 (18.5)

Neutral

15 (27.8)

Agree

9 (16.7)

Strongly Agree

If weight loss drugs were on formulary, I would prescribe them more frequently

2.7 (1.0)

7 (12.7)

Strongly Disagree

18 (32.7)

Disagree

16 (29.1)

Neutral

14 (25.5)

Agree

0

Strongly Agree


1 Scale of 1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree, 5 = strongly agree

Forman-Hoffman et al. BMC Family Practice 2006 7:35   doi:10.1186/1471-2296-7-35

Open Data