Knowledge, attitudes, and practices in obesity among trained and in-training primary care providers in an urban safety-net hospital system

Abstract

Background

Obesity is a highly prevalent, chronic, and treatable disease that disproportionately impacts some minoritized populations who seek care in safety-net settings. Given that primary care providers (PCPs) often serve as the initial point of contact for patients, we aimed to assess their knowledge, attitudes, and practices related to management of obesity.

Methods

This was a cross-sectional study conducted to assess knowledge, attitudes, and practices on obesity management through an anonymous, electronic survey among trained (MD/DO and NP) and in-training (residents) primary care providers (PCPs) in the Departments of Internal Medicine and Family Medicine within an urban safety-net healthcare system.

Results

Among 350 sampled, 96 PCPs completed the survey (27 % response rate). Participants were predominantly (60.4 %) Internal Medicine trainees. The majority of PCPs accurately identified common weight-related comorbidities and improvement of these with >10 % weight loss. Only 25 % of PCPs correctly identified both body mass index (BMI) criteria for anti-obesity medication (AOM) prescription and only 9.1 % identified both BMI criteria for bariatric surgery. Nearly two-thirds (64 %) of PCPs reported prescribing AOMs, with greater comfort in using glucagon like peptide-1 receptor agonist (GLP-1 RA) injectable agents (semaglutide and liraglutide) than with older oral AOMs (phentermine, phentermine-topiramate, and naltrexone-bupropion). Knowledge about side effects and insurance coverage were reported as influencing AOM prescription. Time constraints and lack of training and/or knowledge were identified as barriers in obesity management by more than 50 % of PCPs.

Conclusions

Our study highlights gaps in obesity-related knowledge and practice among PCPs, emphasizing the need for enhanced training, clinical support, and policy reforms to improve obesity management and patient outcomes.