Table 3. Perception and Management of Obesity Among Pakistani Doctors.
BMI: body mass index
| TERMINOLOGY | ||
| Adult: ≥ 18 years | Underweight: BMI <18.5kgs/m2 | Overweight: BMI 25-30kg/m2 |
| Adolescent: 13-17 years | Normal weight: BMI 18.5-25kgs/m2 | Obese: BMI>30kgs/m2 |
| Child: 5-12 years | ||
| A: PRACTICE PROFILE AND DEMOGRAPHICS | ||
| A1 | Which best describes your practice location? | City ☐ Suburban ☐ Town ☐ Rural ☐ |
| A2 | How many doctors, including yourself? | Single-handed ☐ Two ☐ Three or more ☐ |
| A3 | Your gender? | Male ☐ Female ☐ |
| A4 | Your age group? | ≤30 ☐ 31-40 ☐ 41-50 ☐ 51-60 ☐ >60 ☐ |
| A5 | Your specialty? | Family Medicine ☐ Internal Medicine ☐ Surgery ☐ Pediatrician ☐ |
| A6 | What socioeconomic class do the majority of your patients belong to? | Upper ☐ Middle ☐ Lower ☐ |
| A7 | How would you describe the volume of paediatric case handling in your practice? | Small ☐ Average ☐ Large ☐ |
| A8 | Have you completed any courses or training on obesity? | Yes ☐ No ☐ |
| B: ADULT PATIENTS WHO ARE OVERWEIGHT/OBESE | ||
| B1 | How confident are you in conducting health checks on overweight/obese adults? | 1 = NOT CONFIDENT 4 = VERY CONFIDENT 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| B2 | How confident are you in discussing weight issues with an overweight/obese adult when in consultation? | 1 = NOT CONFIDENT 4 = VERY CONFIDENT 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| B3 | How frequently do you discuss with adults, the links between the following conditions and obesity? | 1 = NEVER 4 = VERY FREQUENTLY |
| A | Obesity and cardiovascular disease | 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| B | Obesity and obstructive sleep apnoea | 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| C | Obesity and diabetes | 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| D | Obesity and cancer | 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| E | Obesity and dementia | 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| F | Obesity and surgical risk | 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| B4 | How often do you calculate Body Mass Index (BMI) for: Overweight/obese patients? (b) Patients with apparently normal weight | 1 = NEVER 4 = VERY FREQUENTLY 1 ☐ 2 ☐ 3 ☐ 4 ☐ 1 ☐ 2 ☐ 3 ☐ 4 ☐ | |
| B5 | How important are the following in deterring you from calculating an adult patient’s BMI? Lack of time Cost to the practice Do not want to offend patients Not relevant to presenting complaint Lack of support / resources to provide additional or ongoing care for patients | 1 = NOT IMPORTANT 4 = VERY IMPORTANT 1 ☐ 2 ☐ 3 ☐ 4 ☐ 1 ☐ 2 ☐ 3 ☐ 4 ☐ 1 ☐ 2 ☐ 3 ☐ 4 ☐ 1 ☐ 2 ☐ 3 ☐ 4 ☐ 1 ☐ 2 ☐ 3 ☐ 4 ☐ | |
| B6 | How confident are you in managing the complications of adult obesity, e.g. sleep apnoea, diabetes? | 1 = NOT CONFIDENT 4 = VERY CONFIDENT 1 ☐ 2 ☐ 3 ☐ 4 ☐ | |
| B7 | How confident are you of putting in place a weight management plan to treat an overweight/obese adult? | 1 = NOT CONFIDENT 4 = VERY CONFIDENT 1 ☐ 2 ☐ 3 ☐ 4 ☐ | |
| B8 | How confident are you that an overweight/obese patient will follow such a plan for the subsequent year? | 1 = NOT CONFIDENT 4 = VERY CONFIDENT 1 ☐ 2 ☐ 3 ☐ 4 ☐ | |
| B9 | How important are the following in addressing adult obesity? | 1 = NOT IMPORTANT 4 = VERY IMPORTANT |
| A | The patient | 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| B | The patient’s family | 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| C | General Practitioner | 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| D | Public Health Nurse | 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| E | Dietitian | 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| F | Physiotherapist | 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| G | Psychologist | 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| H | Specialised weight management services | 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| I | Commercial weight management services | 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| J | Better government regulation of the foods/drinks industry | 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| K | Responsible actions/marketing campaigns led from within the food/drinks industry | 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| C: ADOLESCENTS AND CHILDREN WHO ARE OVERWEIGHT/OBESE | ||
| 1=never/not confident 4=always/very confident | ||
| C1 | How often do you weigh and/or calculate a BMI Centile (BMI Z-score*)? * measure of relative weight adjusted for child’s age and sex | 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| C2 | How confident are you discussing overweight/obesity with the parents of overweight/obese patients? | 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| C3 | How confident are you in putting in place a weight management plan to treat a child whom you have identified as being overweight/obese | 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| C4 | Please rate the validity of these statements as potential barriers to addressing childhood obesity in your practice: | |
| 1 = not valid 4 = highly valid | ||
| A | Patients/parents are not receptive to healthy eating and physical activity advice | 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| B | I lack confidence in my own counselling skills regarding childhood obesity | 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| C | There is a lack of evidence of effective intervention | 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| D | There are time constraints | 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| E | There is a lack of support for me to undertake this work in general practice | 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| F | Socio-economic factors affect the ability of families to make a change | 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| G | There is a shortage of local/community-based resources | 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| 1= rarely 4= always | ||
| C5 | When an overweight/obese child presents with an unrelated problem, how frequently do you raise the issue of their weight in the consultation? | 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| C6 | Are parents interested if you discuss their child’s overweight/obesity with them? | 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| C7 | Do you ask overweight/obese children and their parents to return for review of their BMI/weight? | 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| C8 | When you request reviews, do those children and their parents return for follow-up? | 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| C9 | During the last two years, have parents ever become upset by you raising the issue of their child’s overweight/obesity in consultation with them? | 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| C10 | If yes, how many times has this occurred? | 1-2 ☐ 3-5 ☐ >5 ☐ |
| D: ACCESS TO SERVICES | ||
| D1 | Please indicate the level of access to each of these services in your practice for obese patients | |
| 1 = not accessible 4 = very accessible | ||
| A | Dietitian | 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| B | Physiotherapist | 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| C | Psychologist | 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| D | Public Health Nursing | 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| E | Specialised weight management services | 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| D2 | How often do you recommend commercial weight management programmes | 1=never 4=always 1 ☐ 2 ☐ 3 ☐ 4 ☐ |
| E: OPTIONAL * | ||
| E1 | How often do you check your own weight or calculate your BMI? | <1 time/year: ☐ 1 - 4 times/year: ☐ Monthly: ☐ Weekly: ☐ |
| E2 | How would you classify your own bodyweight? | Underweight: ☐ Normal weight: ☐ Overweight: ☐ Obese: ☐ |
| F: COMMENTS |
| If there are additional aspects of care that you wish to highlight, any other observations or comments would be appreciated |