Factors affecting weight counseling attitudes and behaviors among U.S. medical students.

PURPOSE To identify the factors associated with perceived relevance and reported frequency of weight counseling among medical students. METHOD The authors surveyed all medical students in the Class of 2003 at 16 U.S. medical schools during first-year orientation (1999), orientation to wards (2000-2001), and fourth year (2002-2003). RESULTS Across the three time points, response rates were, respectively, 89% (1,846/2,080), 82% (1,630/1,982), and 77% (1,469/1,901); a total of 2,316 medical students participated. More than half of the students felt that weight counseling was highly relevant to their intended practice (respectively, 63% [1,149/1,812], 70% [1,050/1,509], and 54% [717/1,329]). Among fourth-year students, 25% (350/1,393) reported that they "usually-always" provided weight counseling to general medicine patients. Perceived relevance peaked at orientation to wards (odds ratio [OR]=1.88), then declined to initial levels.Greater school support for health promotion was positively associated with high counseling frequency (OR=1.06). Students interested in non-primary-care specialties were less likely than others to consider weight counseling highly relevant (OR=0.59) or, in their fourth year, to provide it to patients (OR=0.50). Finally, higher personal fruit/vegetable consumption and confidence that this intake would increase were positively associated with high perceived relevance (both OR=1.07) and frequency of weight counseling (OR=1.09 and 1.16, respectively). CONCLUSIONS The majority of medical students consider weight counseling relevant to their intended careers. Promoting healthy personal behaviors and encouraging acquisition of skills in weight management across all specialties would likely improve clinical practice.