Bleich and colleagues examined concordance between patient and physician assessments of patient self-reported use of weight-management activities. They analyzed baseline data from a randomized controlled trial of patient and physician interventions designed to improve patient-physician communication (41 physicians and 274 of their patients). 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, and no agreement between patient and physician assessments of patient self-reported efforts to lose weight, mean kappa -0.14. 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).

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: The study showed that primary care physicians differed considerably from their patients, especially obese patients, in their assessments of patient use of weight-management activities.

WHAT THE STUDY MAY MEAN TO YOU AS A PATIENT: The findings are not surprising: both physicians and their patients were looking at the problems through different glasses. The only way that there could be some agreement is if standard criteria, agreed on by both parties, would be adopted. This is why self-monitoring is so important. Patients who keep accurate data on their weight and activities can review this information with their physicians. The data provides a standard for both parties to review. In doing so, it could also improve communication between the two groups, physicians and patients.

SN Bleich et al. Patient use of weight-management activities: A comparison of patient and physician assessments. Patient Education & Counseling, February 27, 2010.