SLU research finds hospital physicians fail to identify, address weight issues in children

Physicians and physician trainees fail to identify or address overweight/obesity in over 90 percent of hospitalized children, according to new research from a Saint Louis University pediatric hospitalist.

"Physicians and Physician Trainees Rarely Identify or Address Overweight/Obesity in Hospitalized Children" was published online Aug. 5 in The Journal of Pediatrics.

Study author Marta King, M.D M.Ed., assistant professor of pediatrics at Saint Louis University School of Medicine, says this represents a missed opportunity for both patient care and physician trainee education.

"Overweight/obesity is the most common chronic pediatric disease in the United States," said King, who is also a SLUCare Physician Group pediatrician. "Physicians who recognize overweight/obesity can provide healthy weight counseling, inpatient consultations and outpatient referrals and thereby have the opportunity to improve outcomes for children with this severe and potentially life-threatening disease."

According to the Centers for Disease Control and Prevention, overweight is defined as a BMI at or above the 85th percentile and below the 95th percentile for children and teens of the same age and sex. Obesity is defined as a BMI at or above the 95th percentile.

King and her fellow authors conducted the study at Primary Children's Hospital, a pediatric facility associated with the University of Utah School of Medicine.

Using an administrative database, the CDC BMI calculator and a random sampling technique, King and her co-authors identified a population of 300 hospitalized children ages 2-18 with overweight or obesity. They then reviewed admission, progress and discharge notes written by medical students, interns, senior residents and attending physicians for this group of patients.

"The children were hospitalized on the general medical service for a variety of reasons," King said. "Common diagnoses included asthma, pneumonia and cellulitis."

The study found physicians and physician trainees identified overweight/obesity in 8.3 percent of the overweight patients and addressed it in 4 percent. Attending physicians were most likely to document weight issues in physical exam or assessment, while medical students were least likely to document such issues.

"We were very liberal in our definition of identifying and addressing overweight/obesity," King said. "Physicians received credit for identifying overweight/obesity risk factors if they documented any questions about a child's diet, physical activity, screen time or family history of overweight/obesity. That meant if a single member of the physician team asked a single question about the number of soft drinks a child drinks, frequency of eating meals out or any sports the child might be involved in, it would be counted as identifying overweight/obesity risk factors."