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Psychiatrists’ Perceptions and Practices in Treating Patients’ Obesity

Received March 11, 2008; revised June 13, 2008; accepted August 4, 2008. Drs. J.H. Price, Lichwala-Zyla, Dake, and Jordan are affiliated with the University of Toledo in Ohio; Dr. J.A. Price is affiliated with the ZEPF Community Mental Health Center in Toledo, OH. Address correspondence to James H. Price, Ph.D., M.P.H., University of Toledo, College of Public Health, 2801 W. Bancroft, Mailstop 119, Toledo, OH 43606; jprice{at}utnet.utoledo.edu (e-mail).

OBJECTIVE: This study identified psychiatrists’ perceptions and practices regarding advising and treating obese patients. METHODS: Questionnaires were mailed to a national random sample of 500 members of APA. A three-wave mailing was used to maximize the return rate. The questionnaire contained items on weight control based on the Stages of Change and Health Belief models, Self-Efficacy theory, and the 5As strategy. RESULTS: A total of 236 psychiatrists responded to the survey. Most did not have any formal training during medical school on treating obese patients and three-quarters evaluated their training in psychiatric residency programs on weight loss/control issues as "not adequate at all" or "not very adequate." The majority regularly assisted their obese patients with weight management. Most psychiatrists felt confident to ask, advise, assess, assist, and arrange (5As) regarding weight loss issues and believed that doing so would result in significant weight loss. The majority were more likely to advise obese patients to lose weight when comorbid conditions were present. The most common barriers to aiding obese patients were time constraints, poor patient compliance, lack of clear guidelines and practice tools, limited medical training on the issue, and fear of offending patients. CONCLUSION: Patients can no longer afford to have their psychiatrists provide cursory assistance with obesity. Weight management training should be incorporated into psychiatric residency training and continuing education programs.

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