Are physicians able to identify high-risk abdominally obese individuals? An analysis from the pan-European Survey of HDL‑cholesterol

ABSTRACT

Objectives: Physician perception of the obesity status may influence the approach to the management of cardiometabolic risk factors. The objective of this study was to explore physicians’ perceptions of the obesity status of their patients in comparison with objective measurements of generalised or abdominal obesity.

Research design and methods: The pan-European Survey of high density lipoprotein (HDL)-cholesterol measured the prevalence of low HDL-cholesterol and other cardiometabolic risk factors in 8545 patients in 11 European countries. The survey also included a question, ‘Is your patient obese?’ with possible answers of ‘Yes’ or ‘No’. Answers to this question were compared with actual obesity status, based on standard cut-off values for body mass index (BMI) and waist circumference.

Main outcome measures: Sensitivity and specificity of physicians’ identification of obesity using receiver operating characteristics analysis.

Results: All patients identified as non-obese were subsequently found to have BMI < 30 kg/m². However, 38% of patients identified as obese by physicians did not have BMI ≥ 30 kg/m². It appeared that the presence of abdominal obesity (high waist circumference, present according to US criteria in about half of overweight patients) increased the likelihood of a patient being perceived as obese.

Conclusions: Physicians often overestimate obesity, especially in abdominally overweight patients. In practice, physicians tend to identify as obese a subset of patients at higher cardiovascular risk through high waist circumference.

Key words: :

• Cardiometabolic risk factors
• HDL-cholesterol
• Obesity, abdominal obesity
• Physician perception
• Survey
• Waist circumference