“…This suggests that there are factors, other than those we measured in this paper, which are also associated with our outcome variables of interest. Previous research suggests that low rates of physician diagnosis and weight-related counseling may also be related to inadequate training [16, 28-31], the belief that advice would have little effect on patient behavior [30, 32], the belief that patients are not interested or ready for treatment [28, 30, 33-34], negative attitudes towards obese patients [35-37], the belief that obesity is the responsibility of the patient [38], or the belief that obesity is hard to handle [39]. Health system barriers to effective obesity care, which have been previously identified, include lack of: payment by insurance companies for weight-related counseling and care [30, 40-41], available teaching materials for patients [28, 30], infrastructure support/places to refer patients [42], a reminder system [43], or sufficient staff or consultant support [43].…”