Few pediatricians feel comfortable addressing patients’ weight issues

Elissa Jelalian, assistant professor of psychiatry and human behavior, surveyed more than 1,000 pediatricians practicing in Southern New England. One-fourth reported that they were not at all or only slightly competent, and 20 percent reported feeling not at all or only slightly comfortable.

by Kristen Cole

Pediatricians often miss the opportunity to target weight problems in the youngest segment of the population, according to a new Brown survey,

When more than 1,000 pediatricians practicing in Southern New England were queried about addressing patients’ weight issues during appointments, one-fourth thought they were not at all or only slightly competent, and 20 percent reported feeling not at all or only slightly comfortable.

“Given increasing numbers of overweight kids it would be helpful to focus on earlier intervention efforts,” said Elissa Jelalian, assistant professor of psychiatry and human behavior in the Medical School and staff psychologist at Rhode Island Hospital. Her study was published in a recent Clinical Pediatrics.

It makes sense to incorporate a health promotion message – healthy eating and physical activity – from the very beginning, said Jelalian.

Researchers surveyed the pediatricians with 14 questions covering attitudes toward obesity, approaches toward treatment and referral, and barriers to addressing weight loss problems in children and adolescents.

Physicians estimated that nearly 28 percent of their adolescent patients and 23 percent of their child patients are overweight – figures that are slightly higher than national data.

The frequency with which physicians addressed weight issues with both child and adolescent patients increased incrementally with the patient’s level of overweight. As a result, said researchers, weight issues may not be discussed with a significant majority of mildly overweight patients. Yet preliminary data regarding overweight adults suggest that periodic brief counseling by physicians can effectively contribute to weight-loss efforts.

Insufficient time may be the most frequent obstacle in addressing obesity with children and adolescents, researchers said. Adolescents in particular have competing concerns such as smoking, risky sexual behavior, and substance use.

“We are asking people to do a tremendous amount in that setting in a short amount of time,” said Jelalian. “Given the amount of time physicians have allocated, it’s hard to know what to prioritize.”

But the primary care setting has been identified as critical to the treatment of pediatric obesity, and the findings suggest physicians would benefit from additional training and education in the area. The dangers of childhood obesity range from psychological and social to physical.

Jelalian led the study with Julie Boergers, assistant professor of psychiatry and human behavior, C. Sloan Alday and Rachel Frank. Jelalian received funding from the Department of Psychiatry at Rhode Island Hospital.