Objective: This study reports the prevalence of obesity among patients in a primary care clinic at a university teaching hospital in rural East Texas and explores potential disparities and comorbidities.

Method: The study was a retrospective review of a deidentified, non-relinkable copy of the electronic health records for 6,955 patients who visited the Family Medicine Clinic of the University of Texas Health Science Center at Tyler North Campus between August 31, 2017, and August 1, 2018.

Results: The prevalence of obesity was 43.2% with an increased likelihood of being obese among females compared to males (OR=1.49, 95%CI=1.35, 1.64), among blacks compared to whites (OR=1.24, 95%CI=1.11, 1.38), among patients 40-65 years old compared to those younger than 18 years (OR=8.83, 95%CI=7.31, 10.68) and a reduced likelihood among patients with public insurance/grants (OR=0.88, 95%CI=0.79, 0.98) and self-pay (OR=0.81, 95%CI=0.71, 0.93) compared to those with private insurance. Those who were obese were also more likely to report having hypertension (OR=2.59, 95%CI=2.35, 2.87), and diabetes (OR=3.26, 95%CI=2.85, 3.73).

Conclusion: There is a high prevalence of obesity among rural primary care patients in East Texas especially among the female, minority black and 40-65 years age groups as well as among patients with diabetes and hypertension. With this facility being a teaching hospital, these findings suggest the need for increased emphasis in the training of medical Residents on the screening and management of obesity, metabolic syndrome, and associated comorbidities in these groups, with special focus on the root cause.