NCHS Data Brief ■ No. 237 ■ March 2016

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

Characteristics of Physician Office Visits for Obesity by 

Adults Aged 20 and Over: United States, 2012

Anjali Talwalkar, M.D., M.P.H., and Frances McCarty, M.Ed., Ph.D.

Key findings

Data from the National 

Ambulatory Medical Care 

Survey, 2012

● In 2012, 11 million visits, or 

an annual visit rate of 49 visits 

per 1,000 persons, to physician 

offices for obesity were made 

by adults aged 20 and over.

● Annual visit rates for obesity 

varied by age and sex. 

● Additional chronic 

conditions were listed more 

frequently at visits for 

obesity than at visits for other 

diagnoses. 

● Visits for obesity were 

25% more likely to include 

assessments of height and 

weight and of blood pressure, 

and more than 50% more likely 

to include testing of blood 

glucose and lipids, compared 

with visits for other diagnoses.

● Health education about 

diet and nutrition, exercise, or 

weight reduction was at least 

four times more likely to be 

offered at visits for obesity 

compared with visits for other 

diagnoses.

Obesity, a complex and costly condition, affects more than one-third of adults 

in the United States (1). It raises the risk of morbidity from chronic diseases 

and is a major cause of preventable death (2). Healthy People 2020 objectives 

for weight status include the delivery of weight-related services in health care 

settings (3). This report examines health care visits for obesity by adults aged 

20 and over in 2012. A visit for obesity is one where the provider listed obesity 

as one of the diagnoses for the visit. National estimates on the assessment of 

risk factors and the provision of health-education services at these visits are 

presented. 

Keywords: chronic conditions • health education • National Ambulatory 

Medical Care Survey

What was the obesity visit rate to physician offices for adults 

in 2012, and did visit rates vary by age or sex?

In 2012, 49 visits per 1,000 persons aged 20 and over were made to physician 

offices in the United States for obesity (Figure 1). This amounts to 11 million 

 

Figure 1. Physician office visit rates for obesity, by age and sex: United States, 2012

1

Significant difference between 20–39 age group and all other age groups (p < 0.05). 2

Significant difference between women and men (p < 0.05).

NOTES: Visit rates are based on the U.S. Census Bureau’s July 1, 2012 estimates of the civilian noninstitutionalized population of 

the United States. A visit for obesity is a visit in which obesity is listed by the provider as one of up to three diagnoses for the visit. 

SOURCE: CDC/NCHS, National Ambulatory Medical Care Survey, 2012.

 
NCHS Data Brief ■ No. 237 ■ March 2016

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annual visits or 2% of all visits by nonpregnant, nonpostpartum adults (data not shown).

The visit rate was significantly lower for patients aged 20–39 (32 visits per 1,000) compared with 

older age groups. There was no difference between the visit rates of patients aged 40–59 and 

patients aged 60 and over.

Women had a significantly higher obesity visit rate (60 visits per 1,000) than men (37 visits). 

Were additional chronic conditions listed at physician office visits for 

obesity by adults? 

An additional chronic condition was listed at 73% of visits for obesity compared with 56% of 

visits for other diagnoses (Figure 2).

Hypertension, hyperlipidemia, diabetes, and depression were listed at a higher percentage of visits 

for obesity than at visits for other diagnoses (42% compared with 32%; 27% compared with 20%; 

24% compared with 13%; and 15% compared with 11%, respectively).

Hypertension was the most commonly listed chronic condition at visits for obesity (42%).

Asthma and arthritis were not more likely to be listed at visits for obesity than at visits for other 

conditions. 

 

Figure 2. Physician office visits with selected chronic conditions listed, by visit diagnosis: United States, 2012

1

Difference between visits for obesity and visits for all other diagnoses is statistically significant (p < 0.05). 

NOTE: A visit for obesity is a visit in which obesity is listed by the provider as one of up to three diagnoses for the visit. 

SOURCE: CDC/NCHS, National Ambulatory Medical Care Survey, 2012.

Percent
NCHS Data Brief ■ No. 237 ■ March 2016

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How often were selected health risk factors assessed at visits for obesity 

compared with visits for other diagnoses by adults?

A higher percentage of visits for obesity had both height and weight recorded at the visit (78%) 

than visits for other diagnoses (58%) (Figure 3).

A higher percentage of visits for obesity had blood pressure recorded at the visit (92%) than visits 

for other diagnoses (69%).

Blood glucose or hemoglobin A1c testing and lipid profile testing were more frequently ordered 

at visits for obesity than at visits for other diagnoses. 

There was no difference in assessment of tobacco use at visits for obesity compared with visits 

for other diagnoses.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Figure 3. Physician office visits with selected health risk factors assessed, by visit diagnosis: United States, 2012

1

Difference between visits for obesity and visits for all other diagnoses is statistically significant (p < 0.05). 

NOTE: A visit for obesity is a visit in which obesity is listed by the provider as one of up to three diagnoses for the visit.

SOURCE: CDC/NCHS, National Ambulatory Medical Care Survey, 2012. 

 
NCHS Data Brief ■ No. 237 ■ March 2016

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How often was weight-related health education listed at visits for obesity 

compared with visits for other diagnoses by adults?

Forty percent of visits for obesity had at least one weight-related service listed compared with 9% 

of visits for other diagnoses (Figure 4).

Diet and nutrition education was listed at 33% of visits for obesity and at 6% of visits for other 

diagnoses.

Exercise education was listed at 24% of visits for obesity and at 5% of visits for other diagnoses.

Weight-reduction education was listed at 26% of visits for obesity and at 2% of visits for other 

diagnoses.

 

 

Figure 4. Physician office visits with weight-related health-education services listed, by visit diagnosis: United States, 2012

1

Difference between visits for obesity and visits for all other diagnoses is statistically significant (p < 0.05). 

NOTE: A visit for obesity is a visit in which obesity is listed by the provider as one of up to three diagnoses for the visit.

SOURCE: CDC/NCHS, National Ambulatory Medical Care Survey, 2012. 
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Summary

According to data from 2011 through 2012, 78.6 million adults in the United States are obese 

(1). This report examined visits to physician offices for obesity. The health care delivered during 

these visits, specifically assessment of related risk factors and health education, was significantly 

different from care delivered at visits for other diagnoses. Visits for obesity were more likely to 

include testing for blood glucose and lipids as well as assessments of height, weight, and blood 

pressure. Additionally, weight-related health-education services were more likely to be listed 

at visits for obesity compared with visits for other diagnoses. While health education is offered 

relatively more often at visits for obesity, overall, it is offered at less than one-half of these 

visits. At least one weight-related service was ordered or provided at 40% of visits for obesity. 

Examining office visits for obesity can help monitor and inform ongoing efforts to meet Healthy 

People 2020 objectives for weight status in health care settings. 

Definitions

Diet and nutrition health-education services: Refers to any topics related to the foods or beverages 

consumed by the patient. Examples include general dietary guidelines for health promotion 

and disease prevention, dietary restrictions to treat or control a specific medical problem or 

condition, and dietary instructions related to medications. It also includes referrals to other health 

professionals, such as dietitians and nutritionists. 

Exercise health-education services: Refers to any topics related to the patient’s physical 

conditioning or fitness. Examples include information aimed at general health promotion and 

disease prevention, and information given to treat or control a specific medical condition. It 

also includes referrals to other health and fitness professionals. It does not include referrals for 

physical therapy. 

Visit for obesity: Refers to a visit in which obesity is listed by the provider as one of up to three 

diagnoses for the visit. All physician office visits for obesity are included across all specialties 

(medical, surgical, and primary care specialties). 

Weight-reduction health-education services: Refers to information given to the patient to assist in 

the goal of weight reduction. It also includes referrals to other health professionals for the purpose 

of weight reduction. 
NCHS Data Brief ■ No. 237 ■ March 2016

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Data source and methods

Data from the 2012 National Ambulatory Medical Care Survey (NAMCS) were analyzed. 

NAMCS is an annual, nationally representative survey of visits to nonfederal, office-based 

physicians, excluding the specialties of anesthesiology, radiology, and pathology. It is conducted 

by the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics. 

The 2012 NAMCS sample design and sample size differs from previous years. In 2012, NAMCS 

used a stratified two-stage sample, with physicians selected in the first stage and visits in the 

second stage. The sample size increased fivefold to allow for state-level estimates in the 34 most 

populous states. A sample weight is computed for each sample visit that accounts for design 

stages. The survey data are inflated or weighted to produce unbiased national annual estimates 

of office visits (4). The unweighted physician response rate was 58.7% (59.7% weighted). The 

unweighted visit response rate for the 2012 survey was 39.3% (39.4% weighted).

Up to three visit diagnoses are collected for each sampled visit. The diagnoses are specified by 

the provider, not the patient. A visit for obesity was defined as any listed diagnosis code 278.00 or 

278.01 based on the International Classification of Diseases, Ninth Edition, Clinical Modification 

(5). Visits for obesity include visits to any physician specialty, including medical, surgical, and 

primary care specialties. Visits by patients for pregnancy or postpartum-related diagnoses were 

excluded. 

Recorded height and weight measurements at the visit were not used to calculate body mass index 

and determine or verify a diagnosis of obesity because of the high proportion of visits without 

both height and weight recorded. Height and weight data were not recorded in 44% of visit 

records by nonpregnant, nonpostpartum patients, and they were not recorded in 23% of records 

with a visit diagnosis of obesity. Therefore, using height and weight to define obesity may not 

produce representative national estimates about ambulatory care for obesity. 

Data analyses were performed using the statistical packages SAS version 9.3 (SAS Institute, Cary, 

N.C.) and SUDAAN version 10.0 (RTI International, Research Triangle Park, N.C.). Differences 

in visit characteristics were evaluated with a two-tailed t test at the p < 0.05 significance level. All 

comparisons reported in the text are statistically significant unless otherwise indicated. 

About the authors

Anjali Talwalkar is with the District of Columbia Department of Health. She conducted this 

research while with CDC’s National Center for Health Statistics (NCHS), Division of Health Care 

Statistics. Frances McCarty is with NCHS’ Division of Research and Methodology.
NCHS Data Brief ■ No. 237 ■ March 2016

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References

1. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity among adults: United 

States, 2011–2012. NCHS data brief, no 131. Hyattsville, MD: National Center for Health 

Statistics. 2013.

2. National Heart, Lung, and Blood Institute. Clinical guidelines on the identification, 

evaluation, and treatment of overweight and obesity in adults. National Institutes of Health, 

publication no. 98–4083. 1998.

3. CDC. HealthyPeople 2020 topics and objectives: Nutrition and weight status. Available 

from: http://www.healthypeople.gov/2020/topics-objectives/topic/nutrition-and-weight-status/

objectives?topicId=29. 

4. National Center for Health Statistics. 2012 NAMCS micro-data file documentation. 2014. 

Available from: ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/NAMCS/

doc2012.pdf

5. National Center for Health Statistics. Classification of diseases, functioning, and disability. 

International Classification of Diseases, Ninth Revision, Clinical Modification (ICD–9–CM). 6th 

ed. Hyattsville, MD. Available from: http://www.cdc.gov/nchs/icd/icd9cm.htm. 
NCHS Data Brief ■ No. 237 ■ March 2016

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Suggested citation

Talwalkar A, McCarty F. Characteristics of 

physician office visits for obesity by adults 

aged 20 and over: United States, 2012. 

NCHS data brief, no 237. Hyattsville, MD: 

National Center for Health Statistics. 2016.

Copyright information

All material appearing in this report is in 

the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health 

Statistics

Charles J. Rothwell, M.S., M.B.A., Director

Nathaniel Schenker, Ph.D., Deputy Director

Jennifer H. Madans, Ph.D., Associate 

Director for Science

Division of Health Care Statistics

Clarice Brown, M.S., Director

Alexander Strashny, Ph.D., Associate 

Director for Science

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