Information and communication about overweight in family practice.

Objective: To explore whether the family doctor recognizes the problem of overweight in his patients and if this problem was addressed in the communication between patient and doctor, especially in diabetic and hypertensive patients.

Method: During a period of three months all patients in a German family practice were weighed and measured to calculate their body mass index (BMI). Overweight patients were asked if this issue had been a topic in the communication with their doctor and if he had recommended weight reduction. In addition, the doctor was interviewed about these patients and his concept of counselling and treating obesity.

Results: For 75% (740/979) of all patients attending the practice, the BMI could be determined: 35% of men (116/331) and 29% of women (117/409) were were overweight, and more than half of these patients were recruited to answer a structured questionnaire. Thirty-four percent of these patients did not know their ideal weight and 51% could not remember talking about this issue with the doctor. Communication/information about this issue was ranked as good in 29% of patients and in 19% as poor. We found a moderate association between information about overweight and patients' willingness for and success in weight reduction. Only 64% of obese patients (BMI > or = 30) were considered at risk for later disease and in need of treatment by the family physician. The doctor tended to overlook overweight in hypertensive or diabetic patients.

Conclusion: Our results suggest that more medical attention should be directed to a reliable measurement and documentation of overweight and to respective communication with overweight patients, especially when hypertension and/or diabetes is present.