High Prevalence of Overweight Children in Michigan Primary Care Practices

Journal of Family Practice, Jan, 2000 by Breanna M. Gauthier, John M. Hickner, Mary M. Noel

It is not surprising that obesity is more prevalent in our sample than in the NHANES II and NHANES III surveys; NHANES data was gathered from 1976 to 1980 and 1988 to 1994, respectively, and obesity prevalences are steadily increasing. However, the reason that our patients are more obese than a contemporary sample of Michigan schoolchildren is unknown. The difference may be caused by systematic bias, as neither of the surveys was based on random sampling. However, in the analysis of our adult patients, the prevalence of obesity of patients was much greater than local community prevalences, even after adjusting for socioeconomic stares and medical conditions known to be associated with obesity.[8]

The association between overweight and socioeconomic status in children and adolescents is weak and not statistically significant.[9] We speculate that obese children and adolescents have more physical and psychological complaints than healthy-weight individuals, causing them to visit their physicians more frequently. If they visit the practice more frequently, obese patients are more likely to be included in a survey of consecutive patients, thereby explaining the higher prevalences of obesity in primary care patients. Perhaps obese children or their parents are more worried about their health and therefore more likely to visit the physician for minor complaints. However, no association has been found between obesity and mental illness, although research regarding such an association is considered inconclusive at this time.[10]

CONCLUSIONS

The prevalences of obesity for children and adolescents presenting for care in Michigan primary care practices are higher than the state and national prevalences. Further studies using larger sample sizes, random sampling, and more settings are necessary to confirm or refute our findings. If this prevalence of obesity in primary care patients is confirmed, explanations for the differences should be explored.

* ACKNOWLEDGMENTS *

We would like to thank the following people for their contributions to this study: Charles Kuntzelman, EdD, for providing us with the Michigan schoolchildren data; Nan Kreher, MEd, administration; Teresa Ettenhofer, administration and data analysis; and Kimber Gauthier, Jenny Folcik, and Celeste St. John, data entry.

We would also like to thank the UPRNet and Michigan State University clinics that collected data. They are: Alpena Medical Arts, Alpena; Doctors Park Family Physicians, Escanaba; Dr Victoria Macki's office, Newberry; OSF Medical Group, Gladstone and Escanaba; Gwinn Medical Center, Gwinn; Marquette Medical Clinic, Iron River,. Burns Clinic, St Ignace; Alcona Health Center, Lincoln and Ossineke; East Jordan Family Health Center, East Jordan; Ewen Medical Clinic, Ewen; Northern Menominee Health Center, Spalding; Northern Michigan Health Services, Houghton Lake; Michigan State University-Family Practice at Clinical Center site, East Lansing; and Michigan State University-Family Practice at the Family Health Center, St. Lawrence Hospital, Lansing.