Patient use of weight-management activities: A comparison of patient and physician assessments

Objective: Examine concordance between patient and physician assessments of patient self-reported use of weight-management activities. Methods: Analysis of baseline data from a randomized controlled trial of patient and physician interventions to improve patient-physician communication (41 physicians and 274 of their patients). Results: A majority of patients reported regular exercise (55.6%) and efforts to lose weight, such as eating less (63.1%) while physicians only perceived one-third of patients as engaging in those activities (exercise, 36.6%; weight loss, 33.3%). Kappa scores indicated small agreement between patient and physician assessments of patient self-reported use of exercise, mean kappa 0.28 (range 0.15 to 0.40) and no agreement between patient and physician assessments of patient self-reported efforts to lose weight, mean kappa -0.14 (range -0.26 to -0.01). Obese patients were more likely than non-obese patients to report trying to lose weight or exercising regularly (p<0.05), but physicians were less likely to perceive obese patients as engaging in those activities (p<0.05). Conclusions: Primary care physicians differed considerably from their patients, especially obese patients, in their assessments of patient use of weight-management activities. Practice implications: These results highlight the importance of improving patient-provider communication about weight-management activities, particularly among obese patients.