--- title: "Adult obesity and office-based quality of care in the US. | Sutter Health" description: "Many opportunities are missed for obesity screening and dx, as well as for the prevention and tx of obesity comorbidities, in US office practices." url: "https://www.sutterhealth.org/research/publications/adult-obesity-and-office-care-quality-1055312917" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Adult obesity and office-based quality of care in the US. # Adult obesity and office-based quality of care in the United States. Ma J, Xiao L, & Stafford RS. _Obesity. 17(5):1077–1085._ 2009-05-01 ## Abstract Nationally representative data on the quality of care for obese patients in US-ambulatory care settings are limited. We conducted a cross-sectional analysis of the 2005 and 2006 National Ambulatory Medical Care Survey (NAMCS). We examined obesity screening, diagnosis, and counseling during adult visits and associations with patient and provider characteristics. We also assessed performance on 15 previously published ambulatory quality indicators for obese vs. normal/overweight patients. Nearly 50% (95% confidence interval (CI): 46–54%) of visits lacked complete height and weight data needed to screen for obesity using BMI. Of visits by patients with clinical obesity (BMI ≥30.0 kg/m2), 70% (66–74%) were not diagnosed and 63% (59–68%) received no counseling for diet, exercise, or weight reduction. The percentage of visits not being screened (48%), diagnosed (66%), or counseled (54%) for obesity was also notably higher than expected even for patients with known obesity comorbidities. Performance (defined as the percentage of applicable visits receiving appropriate care) on the quality indicators was suboptimal overall. In particular, performance was no better than 50% for eight quality indicators, which are all related to the prevention and treatment of obesity comorbidities, e.g., coronary artery disease, hypertension, hyperlipidemia, asthma, and depression. Performance did not differ by weight status for any of the 15 quality indicators; however, poorer performance was consistently associated with lack of height and weight measurements. In conclusion, many opportunities are missed for obesity screening and diagnosis, as well as for the prevention and treatment of obesity comorbidities, in office-based practices across the United States, regardless of patient and provider characteristics. [PubMed abstract](http://onlinelibrary.wiley.com/doi/10.1038/oby.2008.653/full) ## Research topics - [Asthma](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Asthma%5C%22%22) - [Cardiovascular Diseases](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Cardiovascular+Diseases%5C%22%22) - [Disease Management](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Disease+Management%5C%22%22) - [Medical Informatics](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Medical+Informatics%5C%22%22) - [Mental Health](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Mental+Health%5C%22%22) - [Obesity](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Obesity%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Profiles of sociodemographic, behavioral, clinical and psychosocial characteristics among primary care patients with comorbid obesity and depression.](https://www.sutterhealth.org/research/publications/characteristics-primary-care-pts-with-obesity-depression-1055312347) Ma J, Xiao L, Lv N, Rosas LG, Lewis MA, Goldhaber-Fiebert JD, Venditti EM, Snowden MB, Lesser L, Ward E. Prev Med Rep. 8:42-50. doi: 10.1016/j.pmedr.2017.07.010. eCollection 2017 Dec. 2017 Aug 05 - Publication ### [Variability in engagement and progress in efficacious integrated collaborative care for primary care patients with obesity and depression: within-treatment analysis in the RAINBOW trial.](https://www.sutterhealth.org/research/publications/obesity-depression-rainbow-trial-within-treatment-analysis-1055312741) Lv N, Xiao L, Majd M, Lavori PW, Smyth JM, Rosas LG, Venditti EM, Snowden MB, Lewis MA, Ward E, Lesser L, Williams LM, Azar KMJ, Ma J. PLoS One. 15(4):e0231743. doi: 10.1371/journal.pone.0231743. eCollection 2020. 2020 Apr 21 - Publication ### [A conceptual model of the role of complexity in the care of patients with multiple chronic conditions.](https://www.sutterhealth.org/research/publications/complexity-in-the-care-of-pts-with-chronic-conds-1055312633) Grembowski D, Schaefer J, Johnson KE, Fischer H, Moore SL, Tai-Seale M, Ricciardi R, Fraser JR, Miller D, LeRoy L; AHRQ MCC Research Network. Med Care. 52 Suppl 3:S7-S14. doi: 10.1097/MLR.0000000000000045. 2014 Mar 01 - Publication ### [Behavioral weight loss and physical activity intervention in obese adults with asthma: a randomized trial.](https://www.sutterhealth.org/research/publications/behavioral-weight-loss-in-obese-asthmatic-adults-1055312842) Ma J, Strub P, Xiao L, Lavori PW, Camargo CA Jr, Wilson SR, Gardner CD, Buist AS, Haskell WL, Lv N. Ann Am Thorac Soc. 12(1):1-11. doi: 10.1513/AnnalsATS.201406-271OC. 2015 Jan 01 - Publication ### [Research Aimed at Improving Both Mood and Weight (RAINBOW) in Primary Care: A Type 1 hybrid design randomized controlled trial.](https://www.sutterhealth.org/research/publications/research-aimed-at-improving-both-mood-and-wt-1055312852) Ma J, Yank V, Lv N, Goldhaber-Fiebert JD, Lewis MA, Kaye Kramer M, Snowden MB, Rosas LG, Xiao L, Blonstein AC. Contemp Clin Trials. 43:260-78. doi: 10.1016/j.cct.2015.06.010. Epub 2015 June 19. 2015 Jul 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/adult-obesity-and-office-care-quality-1055312917#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Adult obesity and office-based quality of care in the US."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/adult-obesity-and-office-care-quality-1055312917#medicalscholarlyarticle","name":"Adult obesity and office-based quality of care in the United States.","headline":"Adult obesity and office-based quality of care in the US.","abstract":"Nationally representative data on the quality of care for obese patients in US-ambulatory care settings are limited. We conducted a cross-sectional analysis of the 2005 and 2006 National Ambulatory Medical Care Survey (NAMCS). We examined obesity screening, diagnosis, and counseling during adult visits and associations with patient and provider characteristics. We also assessed performance on 15 previously published ambulatory quality indicators for obese vs. normal/overweight patients. Nearly 50% (95% confidence interval (CI): 46–54%) of visits lacked complete height and weight data needed to screen for obesity using BMI. Of visits by patients with clinical obesity (BMI ≥30.0 kg/m2), 70% (66–74%) were not diagnosed and 63% (59–68%) received no counseling for diet, exercise, or weight reduction. The percentage of visits not being screened (48%), diagnosed (66%), or counseled (54%) for obesity was also notably higher than expected even for patients with known obesity comorbidities. Performance (defined as the percentage of applicable visits receiving appropriate care) on the quality indicators was suboptimal overall. In particular, performance was no better than 50% for eight quality indicators, which are all related to the prevention and treatment of obesity comorbidities, e.g., coronary artery disease, hypertension, hyperlipidemia, asthma, and depression. Performance did not differ by weight status for any of the 15 quality indicators; however, poorer performance was consistently associated with lack of height and weight measurements. 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