Current practices of obesity pharmacotherapy, bariatric surgery referral and coding for counselling by healthcare professionals

Introduction: Rates of obesity pharmacotherapy use, bariatric surgery and intensive behavioural counselling have been extremely low. Objectives: The primary objective of this study was to survey healthcare provider beliefs, practice and knowledge regarding obesity management. Methods: Primary care physicians (PCPs), OB-GYN physicians and nurse practitioners (NPs) responded to a web-based survey related to drug therapy practice, bariatric surgery referral and reimbursement coding practice. Results: Rates of reported use of obesity pharmacotherapy appear to be increasing among PCPs, which is likely related to the approval of four new obesity pharmacotherapy agents since 2012. Rates of pharmacotherapy use among OB-GYNs and NPs appear much lower. Similarly, few PCPs are averse to recommending bariatric surgery, but aversion among OB-GYNs and NPs is significantly higher. Conclusion: Together, these observations suggest that OB-GYN and NP populations are important targets for education about obesity management. Very few PCPs, OB-GYNs or NPs use behavioural counselling coding for obesity. Better understanding of why this benefit is not being fully used could inform outreach to improve counselling rates.