Obesity management in gynecologic cancer survivors: provider practices and attitudes

Am J Obstet Gynecol. 2013 May;208(5):408.e1-8. doi: 10.1016/j.ajog.2013.02.002. Epub 2013 Feb 6.

Abstract

Objective: Obesity is associated with the development and risk of death from several women's cancers. The study objective was to describe and compare oncologic providers' attitudes and practices as they relate to obesity counseling and management in cancer survivors.

Study design: Society of Gynecologic Oncology members (n = 924) were surveyed with the use of a web-based, electronic questionnaire. χ(2) and Fisher exact tests were used to analyze responses.

Results: Of the 240 respondents (30%), 92.9% were practicing gynecologic oncologists or fellows, and 5.1% were allied health professionals. Median age was 42 years; 50.8% of the respondents were female. Of the respondents, 42.7% reported that they themselves were overweight/obese and that ≥50% of their survivor patients were overweight/obese. Additionaly, 82% of the respondents believed that discussing weight would not harm the doctor-patient relationship. Most of the respondents (95%) agreed that addressing lifestyle modifications with survivors is important. Respondents believed that gynecologic oncologists (85.1%) and primary care providers (84.5%) were responsible for addressing obesity. More providers who were ≤42 years old reported undergoing obesity management training (P < .001) and were more likely to believe that survivors would benefit from obesity education than providers who were >42 years old (P = .017). After initial counseling, 81.5% of the respondents referred survivors to other providers for obesity interventions.

Conclusion: Oncology provider respondents believe that addressing obesity with cancer survivors is important. Providers believed themselves to be responsible for initial counseling but believed that obesity interventions should be directed by other specialists. Further research is needed to identify barriers to care for obese cancer survivors and to improve physician engagement with obesity counseling in the "teachable moment" that is provided by a new cancer diagnosis.

MeSH terms

  • Adult
  • Aged
  • Allied Health Personnel / psychology
  • Attitude of Health Personnel*
  • Directive Counseling / statistics & numerical data
  • Female
  • Genital Neoplasms, Female / complications*
  • Gynecology
  • Health Care Surveys
  • Humans
  • Male
  • Medical Oncology
  • Middle Aged
  • Obesity / complications
  • Obesity / therapy*
  • Patient Education as Topic / statistics & numerical data
  • Physician-Patient Relations
  • Physicians / psychology
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Referral and Consultation / statistics & numerical data
  • Surveys and Questionnaires
  • Survivors*
  • United States