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Background: Obesity is a major cause of morbidity and mortality in the United States. Objective: To assess how frequently Internal Medicine residents identify and manage overweight and obese patients and to determine patient characteristics associated with identification and management of overweight compared with obesity. Design: A cross‐sectional medical record review. Patients: Four hundred and twenty‐four overweight or obese primary care patients from 2 Internal Medicine resident clinics in Connecticut. Measurements: Measurements included the frequency with which obese and overweight patients were identified as such by their resident physicians, patient demographics, and co‐morbid illnesses, as well as use of management strategies for excess weight. Results: In this population of obese and overweight patients, obese patients were identified and treated more often compared with overweight patients (76/246%, 30.9% vs 12/178%, 7.3% for identification, P=.001, and 59/246%, 24.0% vs 11/178%, 6.2% for treatment, P=.001). Overall, only 70/424 (17%) of patients received any form of management. Only higher body mass index (BMI) (BMI≥30 kg/m2compared with BMI 25–29.9 kg/m2) was independently associated with identification of overweight or obesity (odds ratio 7.51%, 95% confidence interval [CI] 3.76 to 15.02) or with any management for excess weight (odds ratio 4.79%, 95% CI 2.44 to 9.42). Conclusions: Our results suggest that Internal Medicine residents markedly underrecognize and undertreat overweight and obesity.

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The digestion of onion waste was conducted in a two-phase anaerobic solids digester. The digestibility of the onion waste was studied using batch and continuous digesters at mesophilic temperature (35° C). The C:N of onion waste was determined to be 20:1. The two-phase anaerobic digestion was first performed under batch conditions with 200 g (wet weight) of onion waste. Biogas yield of onion waste was 0.34-0.47 L CH4 / g VS fed, with methane yields ranging from 50-80%. Total solids (TS) and volatile solids (VS) reduction were 46% and 54%, respectively. The continuous digestion of onion waste was studied at three organic loading rates (OLR) from 0.5 to 2.0 g VS/L/d. The pH in the biogasification reactor was controlled above 7.0 by the addition of hydrated lime. The average methane yield was determined to be 0.35, 0.32, and 0.32 L CH4/gVS fed for OLR of 0.5, 1.0, and 2.0 g VS/L/d, respectively. The results were similar to the yields determined in the batch digestion study. The twophase system allowed the flexibility of adjusting the loading rate of organic acids to the methanogens, which made pH control possible without disruption of the continuous operation of the digester system.