Trends in professional advice to lose weight among obese adults, 1994 to 2000

AbstractCONTEXT: Obesity is a fast-growing threat to public health in the U.S., but information on trends in professional advice to lose weight is limited. OBJECTIVE: We studied whether rising obesity prevalence in the U.S. was accompanied by an increasing trend in professional advice to lose weight among obese adults. DESIGN AND PARTICIPANTS: We used the Behavioral Risk Factor Surveillance System, a cross-sectional prevalence study, from 1994 (n= 10,705), 1996 (n=13,800), 1998 (n=18,816), and 2000 (n=26,454) to examine changes in advice reported by obese adults seen for primary care. MEASUREMENTS: Self-reported advice from a health care professional to lose weight. RESULTS: From 1994 to 2000, the proportion of obese persons receiving advice to lose weight fell from 44.0% to 40.0%. Among obese persons not graduating from high school, advice declined from 41.4% to 31.8%; and for those with annual household incomes below $25,000, advice dropped from 44.3% to 38.1%. In contrast, the prevalence of advice among obese persons with a college degree or in the highest income group remained relatively stable and high (>45%) over the study period. CONCLUSIONS: Disparities in professional advice to lose weight associated with income and educational attainment increased from 1994 to 2000. There is a need for mechanisms that allow health care professionals to devote sufficient attention to weight control and to link with evidence-based weight loss interventions, especially those that target groups most at risk for obesity.

[1]  K. Stange,et al.  Direct observation of nutrition counseling in community family practice. , 1999, American journal of preventive medicine.

[2]  R. Brownson,et al.  Physician advice to reduce chronic disease risk factors. , 1994, American journal of preventive medicine.

[3]  A. Tarlov,et al.  The relationship between patient income and physician discussion of health risk behaviors. , 1997, JAMA.

[4]  L A Palinkas,et al.  Depressive symptoms in overweight and obese older adults: a test of the "jolly fat" hypothesis. , 1996, Journal of psychosomatic research.

[5]  A. Marcus The cancer information service research consortium. , 1998, Preventive medicine.

[6]  G C Hogelin,et al.  The behavioral risk factor surveys: I. State-specific prevalence estimates of behavioral risk factors. , 1985, American journal of preventive medicine.

[7]  R. Kushner,et al.  Barriers to providing nutrition counseling by physicians: a survey of primary care practitioners. , 1995, Preventive medicine.

[8]  R J Prineas,et al.  Comparison of self-reported and measured height and weight. , 1982, American journal of epidemiology.

[9]  H. Nawaz,et al.  Weight loss counseling by health care providers. , 1999, American journal of public health.

[10]  Summary of the 2000 Surgeon General's listening session: toward a national action plan on overweight and obesity. , 2002, Obesity research.

[11]  M. A. van 't Hof,et al.  Nutrition guidance by primary-care physicians: perceived barriers and low involvement. , 1995, European journal of clinical nutrition.

[12]  J. Dixon,et al.  Depression in association with severe obesity: changes with weight loss. , 2003, Archives of internal medicine.

[13]  H. Ra,et al.  Cardiovascular disease risk factors and preventive practices among adults--United States, 1994: a behavioral risk factor atlas. Behavioral Risk Factor Surveillance System State Coordinators. , 1998 .

[14]  K. Fontaine,et al.  Obesity and health‐related quality of life , 2001, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[15]  T. Kottke,et al.  Nutrition counseling in private practice: attitudes and activities of family physicians. , 1984, Preventive medicine.

[16]  E. Finkelstein,et al.  National medical spending attributable to overweight and obesity: how much, and who's paying? , 2003, Health affairs.

[17]  R. Hahn,et al.  Surveillance for waterborne-disease outbreaks--United States, 1995-1996; Cardiovascular disease risk factors and preventive practices among adults--United States, 1994 : a behavioral risk factor atlas , 1998 .

[18]  G. Colditz,et al.  The disease burden associated with overweight and obesity. , 1999, JAMA.

[19]  Acip Prevention and control of influenza : recommendations of the Advisory Committee on Immunization Practices (ACIP) , 2004 .

[20]  S. Folkman,et al.  Socioeconomic inequalities in health. No easy solution. , 1993 .

[21]  K. Stange,et al.  Direct observation of exercise counseling in community family practice. , 1999, American journal of preventive medicine.

[22]  E. Villanueva The validity of self-reported weight in US adults: a population based cross-sectional study , 2001, BMC public health.

[23]  W. Hershman,et al.  Exercise counseling , 1993, Journal of general internal medicine.

[24]  D. Edington,et al.  The costs of body mass index levels in an employed population. , 1999, Statistical bulletin.

[25]  K. Fontaine,et al.  Impact of weight loss on Health-Related Quality of Life , 1999, Quality of Life Research.

[26]  F. Hu,et al.  Overweight and obesity in women: health risks and consequences. , 2003, Journal of women's health.

[27]  U. P. S. T. Force Behavioral counseling in primary care to promote a healthy diet: recommendations and rationale. , 2003, The American journal of nursing.

[28]  E. McCarthy,et al.  Physician counseling about exercise. , 1999, JAMA.

[29]  R. Elashoff,et al.  Implementation of a primary care physician network obesity management program. , 2001, Obesity Research.

[30]  U. P. S. T. Force Screening for obesity in adults: recommendations and rationale. , 2004, American family physician.

[31]  L. Jason,et al.  Chronic Fatigue and Sociodemographic Characteristics as Predictors of Psychiatric Disorders in a Community-based Sample , 2003, Psychosomatic medicine.

[32]  T. Naimi,et al.  Arthritis, body mass index, and professional advice to lose weight: implications for clinical medicine and public health. , 2004, American journal of preventive medicine.

[33]  R. Hahn,et al.  Cardiovascular disease risk factors and preventive practices among adults--United States, 1994: a behavioral risk factor atlas. Behavioral Risk Factor Surveillance System State Coordinators. , 1998, MMWR CDC Surveillance Summaries.

[34]  Territorial Epidemiologists,et al.  Indicators for chronic disease surveillance. , 2004 .

[35]  G A Colditz,et al.  Economic costs of obesity and inactivity. , 1999, Medicine and science in sports and exercise.

[36]  K. Fontaine,et al.  Health-related quality of life in obese persons seeking treatment. , 1996, The Journal of family practice.

[37]  J. Tsui,et al.  Cardiovascular disease prevention counseling in residency: resident and attending physician attitudes and practices. , 2004, Journal of the National Medical Association.

[38]  D. Galuska,et al.  Are health care professionals advising obese patients to lose weight? , 1999, JAMA.

[39]  E L Korn,et al.  Predictive Margins with Survey Data , 1999, Biometrics.

[40]  A. Mokdad,et al.  Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. , 2003, JAMA.

[41]  George Blackburn Comparison of Medically Supervised and Unsupervised Approaches to Weight Loss and Control , 1993, Annals of Internal Medicine.

[42]  R. Kuczmarski,et al.  Effects of age on validity of self-reported height, weight, and body mass index: findings from the Third National Health and Nutrition Examination Survey, 1988-1994. , 2001, Journal of the American Dietetic Association.

[43]  Kurt C Stange,et al.  Direct observation and patient recall of health behavior advice. , 2004, Preventive medicine.

[44]  W. Willett,et al.  Prospective study of body mass index, weight change, and risk of adult-onset asthma in women. , 1999, Archives of internal medicine.

[45]  D. Schoenfeld,et al.  National patterns of physician activities related to obesity management. , 2000, Archives of family medicine.

[46]  M. Potter,et al.  Weight management: what patients want from their primary care physicians. , 2001, The Journal of family practice.

[47]  F Vinicor,et al.  The continuing epidemics of obesity and diabetes in the United States. , 2001, JAMA.

[48]  R. Andersen,et al.  Societal and individual determinants of medical care utilization in the United States. , 1973, The Milbank Memorial Fund quarterly. Health and society.

[49]  D. Tate,et al.  Who reports receiving advice to lose weight? Results from a multistate survey. , 2000, Archives of internal medicine.

[50]  H. Nawaz,et al.  Physician-patient interactions regarding diet, exercise, and smoking. , 2000, Preventive medicine.

[51]  O. Fein The influence of social class on health status , 1995, Journal of General Internal Medicine.

[52]  Katrina M. Krause,et al.  Primary care: is there enough time for prevention? , 2003, American journal of public health.

[53]  McGinnis Jm,et al.  Actual causes of death in the United States. , 1993 .

[54]  J. E. Lincoln,et al.  Actual causes of death in the United States. , 1994, JAMA.

[55]  J. Král,et al.  Quality of life assessment in obesity: physical, psychological, and social function. , 1987, Gastroenterology clinics of North America.

[56]  D. Lawlor,et al.  Aspirin and cognitive function , 2007, BMJ : British Medical Journal.

[57]  R. Andersen,et al.  Understanding the context of healthcare utilization: assessing environmental and provider-related variables in the behavioral model of utilization. , 1998, Health services research.

[58]  G. Oster,et al.  Estimated Economic Costs of Obesity to U.S. Business , 1998, American journal of health promotion : AJHP.

[59]  James R Morrow,et al.  The relationship of body mass index, medical costs, and job absenteeism. , 2003, American journal of health behavior.

[60]  Jacqueline Tratt No Easy Solution , 1996 .

[61]  S Kamen,et al.  The task force. , 1976, Journal of hospital dental practice.

[62]  A. Coulter,et al.  Lifestyle advice in general practice: rates recalled by patients. , 1992, BMJ.