ABSTRACT Background: Severe obesity has increased more than three-fold in prevalence over the past fifteen years in Europe and the United States. Correctly identifying severe obesity permits access to mortality-reducing interventions. We aimed to determine the accuracy of healthcare professionals (HCPs) in recognising severe obesity and the frequency of body mass index (BMI) assessment by HCPs. Methods: We performed two cross-sectional surveys: one of 206 HCPs in Ireland and Canada and another of 515 Irish hospital healthcare records. The first survey evaluated BMI estimation from photographs and the second examined recording of weight and height during outpatient clinic visits. Results: HCPs underestimated the BMI of severely obese people by an average of 22% to 39%. For a patient with a BMI of 52 kg/m2, 35.4% of family physicians appreciated that the patient was severely obese (BMI > 40 kg/m2) compared with 81.0% of endocrinologists. During clinic visits only 18.1% (n = 75), 1% (n = 4) and 0% (n = 0) of patients had their respective weights, heights and BMIs recorded. Conclusions: HCPs frequently fail to recognise severe obesity from photographs and, in our centre, do not routinely record weight or height. Whether patient outcomes can be improved by measuring weight and height during every HCP encounter warrants further study.
Cite this paper
Ahern, T. , Doherty, K. , Kapeluto, D. , Davis, M. , Mulholland, U. , Rossiter, E. , Gilroy, I. , Billfalk-Kelly, A. , FitzPatrick, P. , Daly, L. , Kelleher, C. and O’Shea, D. (2012) Body mass index estimation and measurement by healthcare professionals. Open Journal of Preventive Medicine, 2, 265-271. doi: 10.4236/ojpm.2012.23038.
 Flegal, K.M., Carroll, M.D., Kuczmarski, R.J. and Johnson, C.L. (1998) Overweight and obesity in the United States: Prevalence and trends, 1960-1994. International Journal of Obesity, 22, 39-47.
 Ogden, C.L., Carroll, M.D., Curtin, L.R., McDowell, M.A., Tabak, C.J. and Flegal, K.M. (2006) Prevalence of overweight and obesity in the United States, 1999-2004. Journal of the American Medical Association, 295, 1549-1555. doi:10.1001/jama.295.13.1549
 The Health and Social Care Information Centre. Health Survey for England 2008. The NHS Information Centre for Health and Social Care, Leeds, 2009.
 Popkin, B.M. (2010) Recent dynamics suggest selected countries catching up to US obesity. American Journal of Clinical Nutrition, 91, 284S-288S.
 Garcia-Alvarez, A., Serra-Majem, L., Ribas-Barba, L., Castell, C., Foz, M., Uauy, R., et al. (2007) Obesity and overweight trends in Catalonia, Spain (1992-2003): Gender and socio-economic determinants. Public Health Nutrition, 10, 1368-1378. doi:10.1017/S1368980007000973
 Basterra-Gortari, F.J., Beunza, J.J., Bes-Rastrollo, M., Toledo, E., Garcia-Lopez, M. and Martinez-Gonzalez, M.A. (2011) In-creasing trend in the prevalence of morbid obesity in Spain: From 1.8 to 6.1 per thousand in 14 years. Revista Espa?ola de Cardiología, 64, 424-426.
 Sturm, R. (2007) Increases in morbid obesity in the USA: 2000-2005. Public Health, 121, 492-496.
 McGee, D.L. (2005) Body mass index and mortality: A meta-analysis based on person-level data from twenty-six observational studies. Annals of Epidemiology, 15, 87-97.
 Gregg, E.W., Gerzoff, R.B., Thompson, T.J. and Williamson, D.F. (2003) Intentional weight loss and death in overweight and obese US adults 35 years of age and older. Annals of Internal Medicine, 138, 383-389.
 Sjostrom, L., Narbro, K., Sjostrom, C.D., Karason, K., Larsson, B., Wedel, H., et al. (2007) Effects of bariatric surgery on mortality in Swedish obese subjects. New England Journal of Medicine, 357, 741-752.
 Adams, T.D., Gress, R.E., Smith, S.C., Halverson, R.C., Simper, S.C., Rosa-mond, W.D., et al. (2007) Long-term mortality after gastric bypass surgery. New England Journal of Medicine, 357, 753-761.
 McArtor, R.E., Iver-son, D.C., Benken, D. and Dennis, L.K. (1992) Family practice residents’ identification and management of ob-esity. International Journal of Obesity and Related Metabolic Disorders, 16, 335-340.
 Bardia, A., Holtan, S.G., Slezak, J.M. and Thompson, W.G. (2007) Diagnosis of obesity by primary care physi- cians and impact on obesity management. Mayo Clinic Proceedings, 82, 927-932. doi:10.4065/82.8.927
 Logue, E., Gilchrist, V., Bourguet, C. and Bartos, P. (1993) Recognition and management of obesity in a family practice setting. Journal of the American Board of Family Practice, 6, 457-463.
 Bramlage, P., Wittchen, H.U., Pittrow, D., Kirch, W., Krause, P., Lehnert, H., et al. (2004) Recognition and management of overweight and obesity in primary care in Germany. International Journal of Obesity and Related Metabolic Disorders, 28, 1299-1308.
 Ruser, C.B., Sanders, L., Brescia, G.R., Talbot, M., Hart- man, K., Vivieros, K., et al. (2005) Identification and management of overweight and obesity by internal medicine residents. Journal of General Internal Medicine, 20, 1139-1141. doi:10.1111/j.1525-1497.2005.0263.x
 Polednak, A.P. (2009) Recognition of comorbid diabetes and obesity in hospital records of newly diagnosed cancer patients. Annals of Oncology, 20, 591-592.
 Hendershot, K.M., Robinson, L., Roland, J., Vaziri, K., Rizzo, A.G. and Fakhry, S.M. (2006) Estimated height, weight, and body mass index: Implications for research and patient safety. Journal of the American College of Surgeons, 203, 887-893.
 Melamed, O.C., Nakar, S. and Vinker, S. (2009) Subop- timal iden-tification of obesity by family physicians. American Journal of Managed Care, 15, 619-624.
 Lopez-Jimenez, F., Malinski, M., Gutt, M., Sierra-Johnson, J., Aude, Y.W., Rimawi, A.A., et al. (2005) Recognition, diagnosis and management of obesity after myocardial infarction. International Journal of Obesity, 29, 137-141. doi:10.1038/sj.ijo.0802831
 Setty, A.R., Curhan, G. and Choi, H.K. (2007) Obesity, waist circumference, weight change, and the risk of psoriasis in women: Nurses’ health study II. Archives of Internal Medicine, 167, 1670-1675.
 Bardazzi, F., Balestri, R., Baldi, E., Antonucci, A., De Tommaso, S. and Patrizi, A. (2010) Correlation between BMI and PASI in patients affected by moderate to severe psoriasis undergoing biological therapy. Dermatology and Therapy, 23, S14-S19.
 Naldi, L., Addis, A., Chimenti, S., Giannetti, A., Picardo, M., Tomino, C., et al. (2008) Impact of body mass index and obesity on clinical response to systemic treatment for psoriasis. Evidence from the Psocare project. Dermatol- ogy, 217, 365-373. doi:10.1159/000156599
 Romero-Corral, A., Caples, S.M., Lopez-Jimenez, F. and Somers, V.K. (2010) Interactions between obesity and obstructive sleep apnea: Implications for treatment. Chest, 137, 711-719. doi:10.1378/chest.09-0360
 Bigal, M.E. and Rapoport, A.M. (2011) Obesity and chronic daily headache. Current Pain and Headache Re- ports, 12, 56-61. doi:10.1007/s11916-008-0011-8
 Adams, T.D. and Hunt, S.C. (2009) Cancer and obesity: Effect of bariatric surgery. World Journal of Surgery, 33, 2028-2033. doi:10.1007/s00268-009-0169-1
 Parekh, N., Okada, T. and Lu-Yao, G.L. (2009) Obesity, insulin resistance, and cancer prognosis: Implications for practice for providing care among cancer survivors. Journal of the American Dietetic Association, 109, 1346-1353.
 McWilliams, R.R., Matsumoto, M.E., Burch, P.A., Kim, G.P., Halfdanarson, T.R., de Andrade, M., et al. (2010) Obesity adversely affects survival in pancreatic cancer patients. Cancer, 116, 5054-5062.
 Gisondi, P., Del Giglio, M., Di Francesco, V., Zamboni, M. and Girolomoni, G. (2008) Weight loss improves the response of obese patients with moderate-to-severe chronic plaque psoriasis to low-dose cyclosporine therapy: A randomized, controlled, investigator-blinded clinical trial. American Journal of Clinical Nutrition, 88, 1242-1247.