Endocrine Abstracts (2010) 21 P142

Healthcare professionals frequently fail to recognise severe obesity

Tomas Ahern, Anne McGowan, Maeve Davis, Astrid Billfalk-Kelly & Donal O’Shea


St Columcille’s Hospital, Co Dublin, Ireland.


Severe obesity continues to dramatically increase in prevalence and is associated with significant mortality and morbidity. The American Society of Metabolic and Bariatric Surgery recommends that bariatric surgery only be performed on those with severe obesity. Gastric bypass surgery decreases mortality by 40% at 7.5 years.

Using photographs of volunteers from a hospital based weight management clinic, we performed a survey of endocrinologists, general practitioners (GPs), dietitians, physiotherapists and final year medical students. Members from each group were asked to estimate the body mass index (BMI) of the subjects in the photographs. We hypothesized that healthcare professionals underestimate the BMI of severely obese people.

Estimated BMI (kg/m2)
Actual BMI (kg/m2)Endo-crinologists (n=19)GPs (n=103)Dietitians (n=28)Physio-therapists (n=25)Medical students (n=33)P value
3231.8 (±3.3)29.0 (±3.3)31.1 (±3.4)28.8 (±5.6)<0.0005
4033.1 (±3.7)30.9 (±3.1)31.2 (±2.7)29.4 (±4.0)28.2 (±2.4)<0.0005
5144.3 (±8.9)37.8 (±5.6)41.8 (±5.2)39.2 (±4.9)34.9 (±3.1)<0.0005
5242.7 (±5.1)38.5 (±4.5)42.0 (±5.4)41.0 (±5.3)35.1 (±4.0)<0.0005
7250.2 (±7.8)42.0 (±4.9)48.0 (±6.9)44.4 (±4.7)39.0 (±3.4)<0.0005

Data are expressed as mean (± S.D.).

P values were calculated using Kruskall–Wallis analyses.

We found that 25–72% of healthcare professionals fail to recognise severe obesity (BMI>40 kg/m2) in a patient with a body mass index of 51 kg/m2.

In order to facilitate appropriate therapy, all patient encounters with a healthcare professional must include formal assessment of weight and height.

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