Comparing clinical practice habits among obesity medicine physicians by patient, physician and clinic factors

Abstract

Background: While clinical practice habits vary by patient, physician and clinic factors in primary care, limited research has examined whether differences exist in obesity medicine. Our objective was to compare practice habits by such factors among obesity medicine physicians certified by the American Board of Obesity Medicine (ABOM).

Methods: We conducted secondary analyses of cross-sectional data from the 2023 ABOM Practice Analysis Validation Survey. We included three obesity medicine practice habits - prescribing anti-obesity medications (AOMs), off-label prescribing of medications for weight reduction, and obesity medicine clinical practice hours (4-20 h/week versus >20 h/week). We included patient (patient population), physician (primary medical specialty, years of obesity medicine experience) and clinic factors (practice setting, geographic catchment, accepts insurance for obesity care). We conducted bivariate analyses using Χ² tests.

Results: Among 565 ABOM-certified physicians, 71.5 % had primary medical specialties within primary care and 9.2 % predominantly treated children/adolescents with obesity. Overall, 97.5 % prescribed AOMs and 85.1 % prescribed off-label medications for weight reduction. Fewer physicians who predominantly treated children/adolescents prescribed AOMs compared to physicians with no or limited treatment of children (88.5 % versus 98.4 % and 98.5 %, respectively; p < 0.001). Overall, 41.4 % reported practicing obesity medicine >20 h/week, which was more likely to occur as years of obesity medicine experience increased (i.e., 21.9 ​% among physicians with 1-2 years of experience versus 58.5 ​% with 10+ years; p ​< ​0.001). No significant differences in practice habits occurred by primary medical specialty, practice setting, geographic catchment, or accepting insurance.

Conclusion: Our findings may suggest that ABOM-certified physicians have consistent obesity medication prescribing practices regardless of physician or clinic factors, which may be particularly important to patients seeking pharmacologic treatment. Most ABOM-certified physicians who predominantly treat children/adolescents prescribe obesity medications. These current rates are relatively higher than prior findings among pediatric ABOM-certified physicians, which might help support pharmacologic access for pediatric patients.

Keywords: Anti-obesity agents; Certification; Obesity management; Physicians’ practice patterns.

Fig. 1

Study Flow Diagram for Analytic Sample of Survey Participants. This figure displays the study flow. Abbreviations: ABOM – American Board of Obesity Medicine; US – United States. ∗Candidates could have been excluded for more than one reason; therefore, numbers presented for each exclusion category are not mutually exclusive.