US Pediatrician Practices and Attitudes Concerning Childhood Obesity: 2006 and 2017

Abstract

Objective: To compare primary care pediatricians' practices and attitudes regarding obesity assessment, prevention, and treatment in children 2 years and older in 2006 and 2017.

Study design: National, random samples of American Academy of Pediatrics members were surveyed in 2006, 2010, and 2017 on practices and attitudes regarding overweight and obesity (analytic n = 655, 592, and 558, respectively). Using logistic regression models (controlling for pediatrician and practice characteristics), we examined survey year with predicted values (PVs), including body mass index (BMI) assessment across 2006, 2010, and 2017 and practices and attitudes in 2006 and 2017.

Results: Pediatrician respondents in 2017 were significantly more likely than in 2006 and 2010 to report calculating and plotting BMI at every well-child visit, with 96% of 2017 pediatricians reporting they do this. Compared with 2006, in 2017 pediatricians were more likely to discuss family behaviors related to screen time, sugar-sweetened beverages, and eating meals together, P < .001 for all. There were no observed differences in frequency of discussions on parental role modeling of nutrition and activity-related behaviors, roles in food selection, and frequency of eating fast foods or eating out. Pediatricians in 2017 were more likely to agree BMI adds new information relevant to medical care (PV = 69.8% and 78.1%), they have support staff for screening (PV = 45.3% and 60.5%), and there are effective means of treating obesity (PV = 36.3% and 56.2%), P < .001 for all.

Conclusions: Results from cross-sectional surveys in 2006 and 2017 suggest nationwide, practicing pediatricians have increased discussions with families on several behaviors and their awareness and practices around obesity care.

Keywords: Periodic Survey of Fellows; childhood overweight and obesity; counseling on overweight and obesity; healthy behaviors; management of obesity; pediatric practices; pediatrics; weight assessment.

Figure 1.

PVs of pediatricians who report they assess for overweight/obesity at every well-child visit by survey year. Adjusted percentages are presented. In multivariable logistic regression, 2006 and 2010 responses are significantly lower than 2017 (P < .01), controlling for sex, age, region, work area, work setting, practice time in general pediatrics >50% of time, and total hours worked per week in direct patient care. *Plot weight-for-length on growth chart was not asked in 2010.

Figure 2.

PVs of pediatricians reporting they make referrals for children and adolescents with overweight, obesity without complications, and obesity with complications: 2006 and 2017. Adjusted percentages are presented. *In multivariable logistic regression, 2006 responses are significantly different than 2017 (P < .05), controlling for sex, age, region, work area, work setting, practice time in general pediatrics >50% of time, and total hours worked per week in direct patient care.