Exploring Genetic Testing for Rare Disorders of Obesity: Experience and Perspectives of Pediatric Weight Management Providers.
Karyn J RobertsEileen ChavesAdolfo J ArizaVidhu V ThakerChi C ChoHelen J BinnsPublished in: Childhood obesity (Print) (2024)
Background: This study describes experiences and perspectives of pediatric weight management (PWM) providers on the implementation of genetic testing for rare causes of obesity. Methods: Purposive and snowball sampling recruited PWM providers via email to complete a 23-question survey with multiple choice and open-ended questions. Analyses include descriptive statistics, Fisher's exact test, one-way ANOVA with Tukey's post hoc test, and qualitative analysis. Results: Of the 55 respondents, 80% reported ordering genetic testing. Respondents were primarily physicians (82.8%) in practice for 11-20 years (42%), identified as female (80%), White (76.4%), and non-Hispanic (92.7%) and provided PWM care 1-4 half day sessions per week. Frequently reported patient characteristics that prompted testing did not vary by provider years of experience (YOE). These included obesity onset before age 6, hyperphagia, dysmorphic facies, and developmental delays. The number of patient characteristics that prompted testing varied by YOE ( p = 0.03); respondents with 6-10 YOE indicated more patient characteristics than respondents with >20 YOE (mean 10.3 vs. mean 6.2). The reported primary benefit of testing was health information for patients/families; the primary drawback was the high number of indeterminate tests. Ethical concerns expressed were fear of increasing weight stigma, discrimination, and impact on insurance coverage. Respondents (42%) desired training and guidance on interpreting results and counseling patients and families. Conclusions: Most PWM providers reported genetic testing as an option for patient management. Provider training in genetics/genomics and research into provider and family attitudes on the genetics of obesity and the value of genetic testing are next steps to consider.
Keyphrases
- weight loss
- primary care
- weight gain
- end stage renal disease
- insulin resistance
- metabolic syndrome
- type diabetes
- case report
- healthcare
- health information
- mental health
- body mass index
- newly diagnosed
- chronic kidney disease
- high fat diet induced
- quality improvement
- prognostic factors
- peritoneal dialysis
- palliative care
- physical activity
- patient reported outcomes
- social media
- systematic review
- randomized controlled trial
- decision making
- social support
- virtual reality
- mental illness
- hiv aids
- ultrasound guided
- antiretroviral therapy
- african american